CARDIAC INTERVENTIONS

Transcatheter aortic valve replacement (TAVR / TAVI)

Transcatheter aortic valve replacement

This new technology has been nominated as one of the most exciting medical innovation of the decade. There was a big gap in the treatment of aortic valve disease (aortic stenosis) in the elderly, as the only treatment of aortic stenosis is surgery, however unfortunately it is only applicable to nearly 50-60% patients, especially in the age group of 65 years and beyond. The prognosis of severe symptomatic AS is worse then many cancers including breast, ovarian , lung and colonic cancers. Hence there was a huge need to treat these patients where surgery was refused or not possible. TAVR is a successful non-surgical alternative to AVR and more than 4 lacs patients have been treated with it with similar results as surgery with less complications rates. The long lasting durability is also now tested upto 10 year and shows excellent outcomes.

There are 2 main type of valves the self-expandable valves and the balloon expandable valves. The procedure is typically done under conscious sedation and take nearly 1 hour for the procedure and patient are mobilized in 24 hrs and discharged in 4 – 5 days timeTranscatheter aortic valve replacement (TAVR) is a minimally invasive procedure to replace a narrowed aortic valve that fails to open properly (aortic valve stenosis). Transcatheter aortic valve replacement is sometimes called transcatheter aortic valve implantation (TAVI).

TAVR may be an option for people who are considered at intermediate or high risk of complications from surgical aortic valve replacement. TAVR may also be indicated in certain people who can't undergo open-heart surgery. The decision to treat aortic stenosis with TAVR is made after consultation with a multidisciplinary group of medical and surgical heart specialists who together determine the best treatment option for each individual. TAVR can relieve the signs and symptoms of aortic valve stenosis and may improve survival in people who can't undergo surgery or have a high risk of surgical complications.

Transcatheter aortic valve replacement
Transcatheter aortic valve replacement

Why it's done

Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure to replace the aortic valve in people with aortic valve stenosis.
Aortic valve stenosis — or aortic stenosis — occurs when the heart's aortic valve narrows. This narrowing prevents the valve from opening fully, which obstructs blood flow from your heart into your aorta and onward to the rest of your body. Aortic stenosis can cause chest pain, fainting, fatigue, leg swelling and shortness of breath. It may also lead to heart failure and sudden cardiac death.
Who benefits most from TAVR
TAVR may be an option if you have aortic stenosis that causes signs and symptoms. For instance, people who are candidates for TAVR may include those who are considered at intermediate or high risk of complications from surgical aortic valve replacement. Conditions that may increase the risk of surgical aortic valve replacement include lung disease or kidney disease — which increase your risk of complications during surgical aortic valve replacement.
TAVR may also be an option if you have an existing biological tissue valve that was previously inserted to replace the aortic valve, but it isn't functioning well anymore.
Before TAVR, you'll need to be tested and evaluated by a multidisciplinary team of heart valve specialists. Doctors will evaluate your condition to determine the most appropriate treatment

Results


Transcatheter aortic valve replacement (TAVR) can improve the lives of people with aortic stenosis who can't have surgery or for whom surgery is too risky. In these people, TAVR can reduce the risk of death. TAVR may also relieve the signs and symptoms of aortic valve stenosis and improve overall health.
Some studies have found that TAVR has similar mortality rates as heart valve surgery in people with aortic stenosis who have an intermediate or high risk of complications from open-heart surgery. You may need to continue taking certain medications after your procedure. Take your medications as prescribed. You'll likely need regular follow-up appointments with your doctor. Let your doctor know if you have any new or worsening signs or symptoms.
Your doctor may recommend that you make healthy lifestyle changes, such as eating a heart-healthy diet, exercising regularly, maintaining a healthy weight and avoiding smoking.


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