Лучшие больницы для «Mitral Valve Repair» в Ченнаи, Индия

The mitral valve is a bicuspid atrioventricular valve that regulates unidirectional blood flow from the left atrium into the left ventricle during diastole. Its competence depends on the coordinated interplay of six anatomical components: the anterior and posterior leaflets, the annulus, the chordae tendineae, the papillary muscles, and the adjacent left ventricular myocardium. When any of these structures are diseased — most commonly due to myxomatous degeneration (Barlow's disease or fibroelastic deficiency), rheumatic fever, infective endocarditis, or ischemic papillary muscle dysfunction — the valve fails to coapt properly during systole, producing mitral regurgitation (MR). Severe MR imposes a chronic volume overload on the left ventricle, leading to progressive eccentric hypertrophy, left ventricular dilatation, reduced ejection fraction, pulmonary hypertension, and ultimately irreversible myocardial dysfunction if left untreated.

• ELIGIBLE CANDIDATES (Indications for Mitral Valve Repair):
• Symptomatic severe primary (degenerative) mitral regurgitation (Stage D MR per AHA/ACC staging) with LVEF > 30%
• Asymptomatic severe MR with left ventricular dysfunction: LVEF 30–60% and/or LVESD ≥ 40 mm (Class I indication)
• Asymptomatic severe MR with preserved LV function when repair is highly likely (>95% probability) at an experienced center (Class IIa indication)
• New-onset atrial fibrillation or pulmonary hypertension (resting PASP > 50 mmHg) attributable to severe MR
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Surgical Mitral VALVE Repair — Standard APPROACHES:

1. CONVENTIONAL OPEN-HEART REPAIR (MEDIAN STERNOTOMY)

The traditional and most widely performed approach. The chest is opened via full median sternotomy, and the heart is arrested using cold cardioplegia on cardiopulmonary bypass (CPB). The Carpentier functional classification guides the specific repair technique employed: Type I (normal leaflet motion — annuloplasty alone), Type II (leaflet prolapse/excess motion — resection or chordal techniques), or Type III (restricted leaflet motion — commissurotomy, decalcification, or pericardial augmentation). This approach is preferred in cases requiring concomitant procedures (CABG, tricuspid repair, Cox-Maze IV for AF ablation).

2. MINIMALLY INVASIVE MITRAL VALVE REPAIR (MINI-THORACOTOMY)

PRE-OPERATIVE PHASE (Days 1–3 in destination):

Day 1 — Arrival & Orientation: GAF Healthcare coordinator meets the patient and attendant at the airport. Transfer to pre-arranged hospital-adjacent accommodation or direct hospital admission. GAF case manager provides orientation to the hospital, introduction to the treating cardiac surgeon and cardiologist, and translation support as required.

Day 2 — Diagnostic Workup: Comprehensive pre-operative evaluation including TTE/TEE, 12-lead ECG, Holter monitor, CCTA or coronary angiography (if not already performed in home country), full laboratory panel, PFTs, anaesthesia review, and STS/EuroSCORE II risk calculation. The cardiac surgeon reviews imaging and confirms surgical plan (repair technique, approach — sternotomy vs. mini-thoracotomy vs. robotic). Informed consent discussion with interpreter support.