Non-surgical procedure: TAVI/TAVR for patients with severe heart valve disease (Aortic Stenosis)
What is Aortic Stenosis?
Aortic valve is one of the four valves in our heart allowing unidirectional flow from one chamber to another. When the aortic valve does not open fully, the condition is termed ‘Aortic Stenosis’. It reduces the blood flow from the heart into the main artery to the body (aorta).
What are the symptoms of Aortic Stenosis?
The typical symptoms include chest pain, breathing trouble, and occasional episodes of blackouts. There will be some unlucky patients who present with sudden cardiac arrest.
A large number of patients are diagnosed with this condition incidentally, and they do not exhibit any symptoms about aortic stenosis. This group of patients is termed as ‘Asymptomatic Aortic Stenosis.'
How do you diagnose Aortic Stenosis?
Based on your symptoms, your doctor will advise you of an echocardiogram (ultrasound of the heart), which is the modality of choice for its diagnosis and assessment of severity.
Some patients may need a CT aortogram (CT scan of the major vessels of the body) for detailed analysis.
How do you treat Aortic Stenosis?
All symptomatic patients need treatment to inform of valve replacement. Traditionally Aortic valve replacement used to be only ‘open heart surgery' which involves opening your chest and replacing the old valve with a new valve.
In the last decade, a minimally invasive surgery known as Transcatheter Aortic valve Implantation/ Replacement (TAVI/TAVR) has provided a good alternative to surgical valve replacement in low, moderate and high surgical risk patients.
It is somewhat similar to placing a stent in an artery, where it delivers a fully collapsible replacement valve to the valve site through a catheter. Once the new valve is expanded, it pushes the old valve leaflets out of the way and the tissue in the replacement valve takes over the job of regulating blood flow. The catheter is introduced mostly through a small incision in a large artery of your groin or arm.
What is the advantage of TAVI/TAVR over surgical valve replacement?
Since the procedure is minimally invasive, you will likely spend less time in the hospital compared to surgical valve replacement. A patient's experience with a TAVR procedure may be similar to a coronary stenting procedure, in terms of recovery.
TAVI/TAVR is not without risk, but it provides a good treatment alternative for patients who may not have been considered for surgical valve replacement either due to personal choice or high surgical risk. TAVI /TAVR can significantly improve the quality of life and prolong life in those with symptomatic Aortic stenosis.
Dr Abhishek Mohanty
MBBS, MD (Gen Medicine), DM (Cardiology)
Consultant Interventional Cardiologist
Department of Cardio