Chronic Rheumatic Heart Disease Double Valve Replacement

Clinical Case Report: Case Study of 59-year-old gentleman from South Sudan with Chronic Rheumatic Heart Disease and triple valve disease, Mitral Stenosis, Mitral Valve Regurgitation, Aortic Regurgitation, Tricuspid Regurgitation who would need a Double valve replacement Surgery with Tricuspid Valve Repair.

According to the shared reports, the patient has Chronic Rheumatic Valvular Heart Disease (CRVHD), which has resulted in severe mitral valve stenosis, mitral valve regurgitation, aortic regurgitation, and severe tricuspid regurgitation.

Chronic Rheumatic Heart Disease (CRHD) is permanent heart valve damage caused by rheumatic fever, an autoimmune response to untreated strep infections. Scarring and narrowing of the valves (typically mitral or aortic) force the heart to work harder, eventually leading to heart failure or abnormal rhythms.

Mitral stenosis and mitral regurgitation are opposing conditions affecting the same valve, but they can occur together. Stenosis is a narrowing that restricts forward blood flow, while regurgitation is a leak that allows blood to flow backward. Together, they severely strain the heart, leading to pulmonary hypertension, heart failure, and arrhythmias.

Severe tricuspid regurgitation is a critical condition where the heart’s tricuspid valve fails to close tightly, allowing blood to leak backward into the right atrium.

We will need to conduct some investigations to confirm the findings upon patient arrival.

Investigations Required: The patient may need to undergo detailed physical evaluation including- CAG, ECG, ECHO, Blood tests, MRI and the entire routine test to confirm the above diagnosis.

Possible treatment plan: The final treatment plan will be decided after complete clinical and physical evaluations. In all possibilities, the patient will require Double Valve Replacement (DVR) Surgery with one valve repair.

In all possibilities, he may need mitral valve and aortic valve replacement along with tricuspid valve repair. However, it is also possible that he may need mitral valve and tricuspid valve replacement. It will be decided only after all the investigations are complete.

Double valve replacement (DVR) is a major open-heart surgery to replace two malfunctioning heart valves (typically the mitral and aortic valves) with prosthetic ones. It is performed under general anesthesia using a heart-lung bypass machine. The procedure relieves severe heart failure symptoms, corrects blood flow, and improves long-term survival.

Tricuspid valve repair is a procedure to fix a damaged or diseased valve between the heart’s right chambers. Surgeons strongly prefer repairing over replacing the valve because it preserves natural heart function and reduces the need for long-term blood-thinning medications.

Kindly note: The advised treatment plan is solely based on the reports shared with us; the final line of treatment will be decided post clinical and physical evaluations of the patient on arrival only.

We’d recommend the following hospitals having Top doctors as below-

1.Amrita Hospitals // Dr. Sameer Bhate

Kindly have a virtual tour of the hospital via gallery – https://pin.it/6VWWsyyzq

2. Artemis Hospital, Gurgaon // Dr. Surendra Nath

Kindly have a virtual tour of the hospital via gallery – https://pin.it/1bs51UAGE

3.Sarvodaya Hospital and Research Centre, Faridabad, Delhi & NCR // Dr. Anupam Das

Kindly have a virtual tour of the hospital via link – https://pin.it/57aR7umFf

4.Aster International Hospital-Bangalore // Dr. Prashanth Y M 

Kindly have a virtual tour of the hospital via gallery – https://pin.it/5K0kkNOBs

5.BLK-MAX Super Specialty Hospital  // Dr. Ramji Mehrotra 

Kindly have a virtual tour of the hospital via gallery – https://pin.it/1Ji84QapI

Stay in India: The patient will require 2-3 days for initial evaluations on an OPD basis. The patient will require 6-7 days of hospitalization for surgery. Post-Discharge patient may require 10-15 days for follow up and recuperation. Total Length Stay in India will be approx. 3-4 weeks.

Estimated cost:

Estimated cost of Initial Evaluations will be approx. USD 800-900 on OPD basis-

Estimated cost of Angiography will be approx. USD 350-450

The Estimated Cost of DVR Surgery + TVR repair (twin sharing) at various hospitals is as below: –

Kindly Note: The given cost is a tentative cost based on the shared information. If the investigations shed a new picture, the cost may vary accordingly.

Inclusions in the costs given–

1. The cost of all investigations related to the treatment.
2. The cost of the treatment.
3. The doctor’s fee and surgery charges.
4. The stay of patient and 1 attendant during hospital admission.
5. All meals for the patient and the attendant as per the available menu while in hospital.
6. Medical Consumables and Medicines while in hospital.
7. The fee for dietician and nursing while in hospital.
8. It also includes complementary Airport Transfers, Forex Services and assistance.

Exclusions:

1. Any consultation other than in discussion
2. Extended stay
3. Treatment for any other illness

On Arrival:

The patient and their attendants will be received at the airport by our Representative. Apart from the medical and nursing team, one Case Manager will take care of all the needs. We shall also assist them with the reasonably charged accommodation near the hospital. The patient and their attendant may arrange 35-50 USD per day for accommodation and food at Guest House.

Hope I have been able to give you a satisfactory answer to the query. Do kindly ask for any clarifications needed. I will be happy to answer and shall look forward to assisting you.

Regards,

Dr. Anmol