Prof. Dr. Ali Serdar Fak
Cardiac SurgeryVerified
- 29+years exp.
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Heart Surgery
Surgery for acquired heart defects
What acquired heart defects are, which operations treat them (valve repair, mechanical or tissue valve replacement, catheter options), how surgeons decide between them, approximate costs in Turkey against the UK, US and Germany, what recovery in hospital and at home involves, the main risks, and how to check a cardiac centre before travelling.
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Dr. Bülent İlçöl
Cardiac SurgeryVerified
- 25+years exp.
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Surgery for acquired heart defects in Turkey: what it treats
An acquired heart defect is a problem with the heart that develops during life rather than being present at birth. In practice the term mostly describes diseased heart valves: a valve that has become narrow (stenosis) so that blood cannot flow freely, or one that no longer closes properly (regurgitation or leak) so that blood flows backwards. Causes include age-related calcification, rheumatic fever, infection of the valve (endocarditis), damage after a heart attack and stretching of the heart or aorta. Surgery for acquired heart defects repairs or replaces the faulty valve, and is sometimes combined with a bypass operation or a repair of the aorta.
This guide covers how the operations work, how surgeons decide between repair and replacement, what the evidence says, what treatment can cost in Turkey compared with the UK, US and Germany, and how to judge a cardiac centre. It does not replace your cardiologist's advice, and nobody should travel for heart surgery without recent scans and a written report. For other options see cardiology treatments in Turkey.
How do I know a valve operation is needed?
The decision comes from imaging and symptoms together. An ultrasound scan of the heart (echocardiography) measures how narrow or leaky the valve is and how the heart muscle is coping. Breathlessness, chest pain, fainting, tiredness and swollen ankles are the symptoms that usually make doctors recommend intervention. Severe disease can be silent, and in some patients surgery is advised before symptoms appear because waiting can permanently weaken the heart.
Not every leak or narrowing needs an operation. Mild and moderate disease is often watched with regular scans and treated with medicines. Surgery is recommended when the valve is severe and the benefit outweighs the operative risk; international guidelines from European and American cardiology societies set out these thresholds, and a second opinion is reasonable if the advice is unclear.
Which operation: valve repair, valve replacement or a catheter procedure?
The choice depends on which valve is affected, why it is diseased, your age and other health conditions. Where it is possible, repair keeps your own valve and is preferred for many leaking mitral valves; for a narrowed aortic valve, replacement is usual. A catheter route, in which a new valve is delivered through an artery, is an option for some older or higher-risk patients.
| Option | Best suited to | Typical limits |
|---|---|---|
| Valve repair | Leaking mitral valve with suitable anatomy | Not possible if the valve is badly calcified or destroyed |
| Mechanical valve replacement | Younger patients who want a valve that lasts decades | Needs lifelong blood-thinning (warfarin) and regular tests |
| Tissue (biological) valve replacement | Older patients, or those who cannot take blood thinners | Wears out over time; a second procedure may be needed |
| Catheter valve (TAVI) | Selected patients with severe aortic stenosis at higher surgical risk | Not suited to every anatomy; see TAVI |
Details of single-valve operations are in our guides to aortic valve replacement and mitral valve repair. Surgeons may also treat two valves at once or add a bypass graft when the arteries are narrowed.
Does surgery for acquired heart defects work, and what does the evidence say?
For severe symptomatic valve disease the evidence is strong that operating improves survival and quality of life compared with waiting. Repair of a leaking mitral valve is associated with more preserved heart function than replacement when it can be done well, which is why units with experience in repair are valued. Mechanical valves are very durable but need anticoagulation; tissue valves avoid that but can degenerate, particularly in younger patients.
What is less certain are the numbers for any individual: outcomes depend on how weak the heart already is, whether the kidneys and lungs are healthy, whether you have diabetes, and how urgent the operation is. Any figure quoted to you should come with the source and the comparison group.
Surgery for acquired heart defects cost in Turkey compared with the UK, US and Germany
The figures below are approximate ranges for a single-valve operation including the hospital stay, not hospital quotes. Costs rise with the number of valves, the valve type and any added bypass or complications.
| Country | Approximate cost range |
|---|---|
| Turkey | €9,000 – €25,000 |
| United Kingdom (private) | €25,000 – €60,000 |
| United States | €70,000 – €200,000 |
| Germany | €25,000 – €55,000 |
What changes the price: repair or replacement, mechanical or tissue valve (the device itself is a significant cost), minimally invasive or standard approach, combined procedures, days in intensive care, and any unplanned complication. A package normally includes the pre-operative tests, the operation, the valve, anaesthesia, intensive care and ward days, medicines, and transfers. Ask what happens to the price if you need a longer stay or a repeat procedure, and ask for that answer in writing.
Who is a good candidate, and who is not?
Candidates are people whose heart team agrees that a severe valve problem is causing symptoms or heart damage and that they are fit enough for the operation. Those at greater risk include people with very weak heart muscle, advanced kidney or lung disease, recent stroke, active infection or frailty. For them, a catheter procedure or continued medical treatment may be safer, and a careful clinic will say so, even if it means you do not have an operation.
You also need to be able to travel safely and to have the follow-up scans and blood tests (for example INR monitoring on warfarin) at home. If you cannot arrange that, mention it at the start.
What happens during the operation, step by step?
- Preparation: blood tests, ECG, chest X-ray, echocardiography and often a CT or coronary angiogram to check the arteries.
- Anaesthesia: general anaesthesia with the heart monitored throughout.
- Access: through the breastbone (sternotomy) or, for suitable cases, a smaller incision between the ribs.
- Heart-lung machine: the heart is stopped briefly while a machine maintains circulation. This is the standard "open-heart" technique (see open-heart surgery).
- Valve work: the surgeon repairs the valve or removes it and sews in a mechanical or tissue replacement.
- Closure: the heart is restarted and the chest is closed, with temporary drains and pacing wires.
The operation usually takes three to five hours, longer for combined procedures. You then wake in intensive care, usually with a breathing tube removed within hours.
Recovery after heart valve surgery: hospital, travel and the first months
Intensive care usually lasts one to two days, followed by around five to seven days on the ward. Expect chest wall soreness, tiredness, a reduced appetite and sometimes an irregular heartbeat that is treated with medicines. Physiotherapists help you walk early and teach breathing exercises. Most surgeons advise staying in Turkey for roughly 10 to 14 days in total so that wounds, rhythm, blood tests and scans can be checked before the flight, and flying is usually allowed once the doctors confirm you are stable.
The breastbone needs six to eight weeks to heal, during which you avoid heavy lifting and driving as advised. Return to desk work after about six to twelve weeks is common; full strength may take three to six months. Cardiac rehabilitation, if offered at home, has good evidence behind it.
What results can you realistically expect?
Most people notice that breathlessness and tiredness lessen over weeks to months as the heart adapts, and many return to normal daily activity. There are no "before and after" photographs that convey the result; the evidence is a repeat echocardiogram showing the valve working and the heart chambers settling. Some patients keep a medical condition, such as an irregular rhythm, that needs continued treatment. Recovery is slower when the heart was already weak before the operation.
Risks and complications of heart valve surgery
Heart surgery is a major operation. Risks include bleeding, infection (including infection of the new valve), stroke, irregular heart rhythm, kidney problems, the need for a pacemaker and, rarely, death. The risk of an individual patient depends heavily on age, the state of the heart and whether the operation is planned or an emergency; the NHS and cardiology societies describe the general risks but not a single number. Long-term, mechanical valves require blood thinners with their own bleeding risk, and tissue valves may need replacing years later. Lifelong follow-up is part of the treatment.
How to choose a cardiac centre, and red flags
Look for a hospital with a cardiac surgeon who performs valve operations regularly, an intensive care unit with cardiac-trained staff, an in-house echocardiography and blood bank, and a multidisciplinary heart team that reviews your case. Ask whether they offer both repair and replacement; a centre that only replaces may not offer repair. Red flags include a firm price quoted without reviewing your scans, pressure to choose a valve type without explanation, no clear plan for anticoagulation monitoring after you leave and promises that the operation carries no risk.
Questions to ask the clinic:
- Which valve operation do you recommend for me, and why not the alternatives?
- Will you repair my valve if possible, and what is the chance you will have to replace it?
- Is a mechanical or tissue valve proposed, and what does that mean for blood thinners?
- How many days in intensive care and in hospital are included?
- What happens if complications keep me in hospital longer?
- Who can follow me at home, and will I receive a full operation report?
You can read how it works for the steps from first enquiry to the trip, or send your reports through a free quote.
Hospitals with Cardiac Surgery in Turkey
Frequently asked questions
It is an operation to repair or replace a heart valve that has narrowed or leaks because of age, infection, rheumatic fever or other damage during life. It is sometimes combined with a bypass operation or aortic repair.
For severe valve disease causing symptoms, surgery generally improves survival and quality of life compared with waiting. How much benefit you get depends on the valve involved, the strength of the heart and any other illness.
A single-valve operation with hospital stay is approximately €9,000 to €25,000 in Turkey, against about €25,000 to €60,000 in UK private care. The valve type, combined procedures and intensive care days change the final price.
It depends on the valve and its condition. Repair keeps your own valve and is preferred for many leaking mitral valves; replacement is usual for narrowed aortic valves. The heart team should explain the reasoning for you.
A mechanical valve lasts for decades but needs lifelong blood thinners. A tissue valve usually avoids blood thinners but can wear out, so it may need replacing after ten to fifteen years or more.
Expect about a week in hospital, six to eight weeks for the breastbone to heal and three to six months to regain full strength. Many people return to desk work within six to twelve weeks.
You are under general anaesthesia during the operation. Afterwards chest soreness is expected and treated with painkillers, which most people find manageable and which eases over a few weeks.
It is major surgery with real risks, including bleeding, infection, stroke and rhythm problems. Risk depends on your age, heart function and other illnesses, so ask for a risk estimate based on your own tests.
For some patients with severe aortic stenosis, a catheter-delivered valve (TAVI) is an option. It is chosen after assessment of anatomy and surgical risk and is not suitable for everyone.
Plan roughly 10 to 14 days in total, including intensive care and ward stay, so wounds, heart rhythm, blood tests and scans can be checked before flying. Your surgeon decides when travel is safe.
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