Transcatheter Aortic Valve Replacement

Transcatheter Aortic Valve Replacement

transcatheter-aortic-valve-replacement.jpg
  • The aortic valve guards flow of blood from the heart to the rest of the body. The major blood vessel that carries blood to the various organs of the body is the aorta and hence this valve is named aortic valve.
  • Aortic stenosis is a condition where the aortic valve narrows due to various causes. Most commonly ageing consequent degeneration of aortic valve causes the narrowing thus restricting blood flow to other organs.
  • Transcatheter Aortic Valve Replacement (TAVR or TAVI) is a procedure where the damaged valve is replaced by an artificial valve.
  • TAVR is a minimally invasive procedure and does not require splitting open of chest or general anaesthesia.
  • Through an incision, in the groin, an aortic valve mounted on a catheter will be introduced into the heart.
    • Aortic valve degenerates with ageing due to wear and tear. This happens usually beyond the age of 65 years. Many at that age have associated issues like previous heart surgery, kidney dysfunction, blocks in blood vessels supplying heart and brain, age-related frailty, lung problems etc. These issues make them a high risk for open-heart surgery.
    • Initially, TAVR was indicated for high-risk patients but for the past 5 years is being used in intermediate-risk and selected low-risk cases also.
    • Then, an artificial valve is directed into the aortic valve, where it can be expanded and further takes over the function of a diseased valve resulting in improved blood flow.TAVR became a revolutionary popular procedure?
      • High riskforopen-heart surgery
      • History of kidney or lung diseases and cannot undergo invasive procedures/surgery
      • Having previous valve replacement surgery that gets narrowed again.

      Who are not eligible to undergo TAVR procedure?

      • Previous mechanical valve surgery at the aortic valve location.

      What are the risks of the TAVR procedure?

      Generally, the TAVR procedure is safe and effective. However, some problems may occur in 1-3% of cases based on an individual’s characteristics which include:

      • Bleeding due to damage of blood vessels
      • Brain stroke
      • Infection
      • Heart attack
      • Kidney failure
      • Failure of the new artificial valve

      What are the potential complications of the TAVR procedure?

      • Paravalvular regurgitation
      • Pacemaker implantation
      • Valve thrombosis
      • Bleeding
      • Infective endocarditis
      • Death

      These can potentially affect 0.5-7% of patients.

      What are diagnostic tests to undergo before the TAVR procedure?

      • Electrocardiogram
      • Echocardiogram
      • Transesophageal echocardiogram
      • Carotid Ultrasound
      • CT aortogram

      What happens during TAVR procedure?

      • Small incisions are made in the groin for catheter insertion. Ongoing X-ray imaging will guide the catheter towards the aortic valve and the balloon at the end of the catheter may be inflated to open the aortic valve.
      • Then an artificial aortic valve will be directed through the catheter and placed over the diseased valve and deployed.
      • Echocardiography will be done to check for the functioning of the new aortic valve.

       

      What happens after the TAVR procedure?

      • Vitals such as Blood pressure, heart rate, temperature, respiration rate, blood oxygen level will be monitored, the patent is restedin the ICU for 24 hours.
      • Patient hospital stay will be 2 to 4 days.
      • If the catheter insertion is at the groin area, you may ask for not bend or cross your legs
      • Infections and bleeding manifestations are checked at the insertion site
      • You will be instructed to keep hydrated that will help you in washing off the contrast dye
      • Blood tests, Chest X-ray,Electrocardiogram(ECG), Echocardiogram will be done

       

      How long does my TAVR procedure last?

      • TAVR is a durable procedure and lasts for 10 to 20 years in the absence of complications.
      • Compared to surgical replacement of the aortic valve, TAVR provides a larger valve area and hence chances for re-narrowing are less.

       

      What is the uniqueness of treatment of TAVR by Dr C Raghu?

      • Availability of multimodality imaging leading to accurate diagnosis of the problem and associated co-morbidities.
      • One of the earliest cardiologists in India to have performed TAVR.
      • The first operator in South India to have performed TAVR in a patient with a previous mitral valve replacement.
      • Excellent pre-procedure planning leading to a highly successful result.

      Keywords:

      Open heart surgery

      Mechanical valve

      Pacemaker

      Valve Thrombosis

      Infective endocarditis

      Echocardiograms

      Carotid ultrasound

      Ct Aortogram

      Artificial aortic valve

      TAVR procedure

      Fast recovery rate

      Small incision

      Cardiologist

      Mitral valve replacement

      Who are eligible to undergo TAVR procedure?



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Copyright © 2019, Dr C Raghu. All rights reserved.
Designed & Developed by R R Deepak Kambhampati.



Copyright © 2019, Dr C Raghu. All rights reserved.
Designed & Developed by R R Deepak Kambhampati.