Emergency No: 08062136599
Cardiac Surgery | by Dr. Manoj Kumar Daga | Published on 09/09/2024
This breakthrough procedure is more advanced than a standard valve replacement. Where no other procedure guarantees long-term benefits, this procedure provides a statistically significant mortality rate and is regarded as a boon for people who were considered inoperable. It was first tested in 2002 on patients with severe aortic stenosis (a narrowing of the aortic valve opening), who were considered unfit for open heart surgery. TAVI/TAVR outperformed in the trials with patients significantly better recording a higher mortality rate.If you have just been told you might need one or your loved one, book your appointment with one of the best cardiologists in Kolkata at BM Birla Heart Research Hospital for proper diagnosis and to learn what’s best for you.
A Transcatheter Aortic Valve Replacement (TAVR) or Transcatheter Aortic Valve Implantation (TAVI) is a surgical method performed to repair a compromised, blocked or narrowed artery which was disrupting the blood and oxygen supply to the heart. This surgical procedure is recommended for patients who have a higher risk or are too sick, or too old for open heart surgery.
TAVI/TAVR procedure treatment offers several benefits which include:
Fig 1: Benefits of a TAVI/TAVR Procedure
When a patient is considered high risk or unable to undergo open heart surgery, the Transcatheter Aortic Valve Replacement (TAVR) or Transcatheter Aortic Valve Implantation (TAVI) operation is usually advised. For some heart diseases, this less invasive method provides a helpful alternative. Following are some of the situations in which TAVR/TAVI is recommended:
Risks involved in a TAVI/TAVR procedure include:
Though uncommon, these risks are important to be aware of before evaluating all options of treatment. Even the doctor will conduct several tests such as an ultrasound,echocardiogram, cardiac CT scan, and cardiac catheterization to determine if a TAVI/TAVR procedure is best suited to your condition.
While the surgery is less invasive, it is still very crucial to undertake proper precautions and follow accurate instructions to prepare for the surgery. The doctor might advise you to get some check ups done, ensure proper health, be mentally sure, and physically stable, and have family and friends to take care and support. The patient will need to shave off the hair from the area of insertion of the catheter, come to the hospital a day in advance, and ensure you consult your doctor about what foods to avoid and eat, any medications to take, or if you have any allergic reactions. The procedure is performed under local anaesthesia.
A TAVI/TAVR procedure can be performed in two ways:
These two procedures reduces the symptoms of severe aortic valve stenosis such as:
The Transcatheter Aortic Valve Replacement (TAVI/TAVR) procedure involves the implantation of the aortic valve via a catheter without removing the damaged, old valve. Instead, TAVI/TAVR wedges another valve into the aortic valve’s place (valve-within-valve). The approach is very similar to the placement of a stent – a stainless steel mesh – in the artery. In a TAVI/TAVR procedure, a small incision either through the upper chest or groyne is made to place a small, hollow fine tube (sheath) that provides access to the aortic valve by placing a catheter mounted with a balloon. Once the catheter is in place, the balloon is inflated at the termination point to push the plaque to the sides.
Once the compromised valve is opened, a completely collapsible valve (artificial, biological, or a combination of the two) in replacement, on the site of the old valve is placed through the catheter. Once the placement is made, the new valve expands and drives the old one out of place, enabling the new tissue in the valve to become the primary medium of regulating blood flow in the heart. Post successful positioning, the balloon is deflated and removed.
Patients must adhere to particular post-operation recommendations following a transcatheter aortic valve replacement (TAVR) or transcatheter aortic valve implantation (TAVI) procedure to ensure a proper recovery and prevent problems. Usually, these guidelines state:
The TAVR/TAVI treatment provides a less invasive option for patients who are at high risk for standard open-heart surgery and for addressing problems like severe aortic stenosis. The process is a life-saving option that enables a quicker recovery and an enhanced quality of life thanks to developments in technology and medical knowledge. To guarantee the best results, it is essential to adhere to post-procedure instructions and schedule routine follow-ups with your healthcare provider, just like with any medical intervention. You should always speak with your cardiologist to find out if TAVR/TAVI is the best course of action for you.
Depending on the hospital, the patient's health, and the location, the cost of the TAVI/TAVR treatment might differ from INR 15 lakhs to INR 25 lakhs. Pre-procedure testing, the actual procedure, and the care given after the procedure are all included. Consult your healthcare provider as prices may vary.
After TAVR/TAVI, patients often stay in the hospital for three to five days, depending on their general condition and recovery. If their recovery goes well, some patients might be discharged sooner, while others might need to stay longer for monitoring purposes.
Patients with severe aortic stenosis who are at high or intermediate risk for standard open-heart surgery because of their age, pre-existing medical disorders, or fragility are usually good candidates for TAVR/TAVI. A comprehensive assessment conducted by a heart team is necessary to ensure the eligibility of a candidate.
