Heart Valve Disease Treatment in Raipur

Heart valve disease (HVD) occurs when one or more of the four heart valves (they are the mitral, aortic, tricuspid, and pulmonary) fail to open fully (a condition called stenosis or narrowing that restricts forward flow) or fail to close completely (regurgitation or leaking of blood backwards). HVD contributes to heart failure and stroke, where rheumatic fever remains the dominant cause in adults under 40. Ramkrishna CARE Hospitals, Raipur provides complete valve assessment and treatment, from echocardiography to TAVI (transcatheter aortic valve implantation).

Types of Heart Valve Disease

Each of the four valves can develop stenosis (narrowing) or regurgitation (leaking), producing distinct haemodynamic disturbances:

• Aortic stenosis (AS): The narrowing of the aortic valve is the most common valve lesion in adults over 65 in India. Its primary causes are calcium buildup on the aortic valve as we age and congenital valve defects.
• Aortic regurgitation (AR): It allows blood to leak back into the left ventricle
• Tricuspid regurgitation (TR): It is most commonly functional, caused by right ventricular dilatation from pulmonary hypertension.
• Mitral stenosis (MS): It is almost exclusively caused by rheumatic heart disease (RHD). In this condition leaflets fuse and the subvalvular apparatus thickens, obstructing left ventricular filling. 
• Mitral regurgitation (MR): It occurs when the mitral leaflets fail to meet during systole. Its causes include leaflet prolapse, RHD, ischaemic papillary muscle dysfunction, and annular dilatation.

Symptoms of Heart Valve Disease

Symptoms depend on the valve affected and the defect type:

• Breathlessness: Dyspnoea or difficulty breathing on exertion is the earliest and most common symptom of left-sided valve disease, progressing to orthopnoea (breathlessness when lying flat) and paroxysmal nocturnal dyspnoea (sudden severe breathlessness waking the patient from sleep). 
• Chest pain (angina): It occurs in severe aortic stenosis because the hypertrophied (thickened) left ventricle outstrips its coronary blood supply.
• Syncope or exertional syncope in aortic stenosis: It indicates severe outflow obstruction and requires urgent assessment. 
• Palpitations: They result from atrial fibrillation triggered by atrial dilatation.
• Other symptoms: Fatigue, ankle swelling, and ascites (fluid in the abdominal cavity) reflect low cardiac output and elevated venous pressure.

Causes of Heart Valve Disease

Identifying the cause of HVD determines the treatment strategy:

• Rheumatic heart disease (RHD): It is one of the most important causes of valve disease in patients under 50. Recurrent rheumatic fever which is triggered by inadequately treated streptococcal pharyngitis (a sore throat) causes leaflet thickening, calcification, and fusion of the mitral valve. 
• Degenerative valve disease or age-related calcification of the aortic valve: It is the dominant cause in patients over 65. Bicuspid aortic valve (BAV), in which the aortic valve has two leaflets instead of three, accelerates calcification and predisposes to AR and aortic root dilatation. 
• Infective endocarditis: IE or infection of the valve leaflets, most commonly by Staphylococcus aureus can destroy a valve within days, requiring emergency surgery.

Diagnosis of Heart Valve Disease

Diagnosis confirms the valve lesion, grades the severity and assesses left ventricular function to determine the timing and type of intervention.

• TTE (transthoracic echocardiography): This cardiac ultrasound with a probe on the chest wall measures valve area, gradient (pressure difference across the valve), and LVEF (left ventricular ejection fraction). 
• TOE (transoesophageal echocardiography): An ultrasound probe in the oesophagus gives detailed images of valves and detects infective growths on the valve leaflets (a sign of IE). 
• Cardiac CT: It measures the aortic valve calcium score and assists in planning TAVI.

Treatment for Heart Valve Disease

Treatment depends on the affected valve, lesion type and severity, symptoms and left ventricular function:

• Medical therapy: It controls symptoms and reduces procedural risk but does not reverse valve pathology. 
• Beta-blockers and rate-limiting calcium channel blockers slow the heart rate in mitral stenosis and atrial fibrillation. 
• Diuretics to reduce oedema. 
• Warfarin (an anticoagulant) is mandatory in heart valve disease patients with atrial fibrillation or mechanical valve prostheses; monthly 
• Benzathine penicillin prevents RHD progression.
• PBMV (percutaneous balloon mitral valvuloplasty): It is the treatment of choice for suitable mitral stenosis - a catheter passed across the atrial septum inflates a balloon, splitting the leaflets
• Surgical valve repair: Leaflet resection, chordal replacement, and an annuloplasty ring can achieve durable correction of degenerative MR.
• Surgical valve replacement: It is performed when repair is not feasible. A mechanical prosthesis (most commonly a bileaflet carbon valve) lasts indefinitely but requires lifelong anticoagulants with careful INR monitoring. A biological prosthesis (tissue valve) does not require long term anticoagulation but has a lifespan of 15 to 20 years. 
• TAVI (transcatheter aortic valve implantation): It deploys a valve via the femoral artery without open surgery and is indicated for high-risk and intermediate-risk patients.

Risk Factors for Heart Valve Disease

Some HVD risk factors are modifiable; addressing them slows progression and reduces surgical risk. They are:

• Prompt antibiotic treatment of sore throat prevents the initial episode of rheumatic fever
• Secondary prophylaxis (monthly benzathine penicillin injections) prevents recurrence and halts RHD progression. 
• Hypertension accelerates aortic valve calcification there should be controlled
• Good dental hygiene and antibiotic prophylaxis before high risk dental procedures reduce infective endocarditis risk in patients with mechanical valve prostheses or previous IE.

Complications of Heart Valve Disease

Untreated HVD leads to irreversible damage and life-threatening events:

• Heart failure is the most serious HVD complication; in AS
• Stroke 
• Pulmonary hypertension
• Blood clots (thromboembolism)
• Enlarged heart chambers
• Cardiogenic shock
• Syncope (fainting)
• Reduced exercise capacity.

Why Choose Ramkrishna CARE Hospitals for Heart Valve Disease Treatment in Raipur?

Ramkrishna CARE Hospitals, Raipur provides complete valve care ranging from echocardiographic assessment to percutaneous and surgical intervention. All cases are reviewed by our multidisciplinary team involving cardiologists, cardiac surgeons, and imaging specialists. The hospital performs PBMV for rheumatic mitral stenosis, open mitral valve repair and replacement, aortic valve repair and replacement, and TAVI for high- and intermediate-risk aortic stenosis patients.

The cardiac surgery programme operates with a modern hybrid operating theatre supporting complex valve procedures. Postoperative care is provided in a dedicated cardiac intensive care unit. All surgical patients receive annual echocardiography, INR monitoring for anticoagulated patients and dental hygiene counselling to reduce endocarditis risk - serving patients from Raipur and across Chhattisgarh.