A non surgical alternative to open heart surgery- TAVI for the first time in Kerala

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January 8, 2015
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January 8, 2015

A non surgical alternative to open heart surgery- TAVI for the first time in Kerala

What is TAVI ?
Transcatheter aortic valve implantation (TAVI) is also know as Transcatheter aortic valve replacement (TAVR). Using an approach similar to the approach used for cardiac catheterization of the coronary arteries, TAVI involves a puncture though the skin into the blood vessels in the groin. A catheter, about as wide as a pencil, is then threaded up through vessels in the leg into the aorta then into the heart. A special valve is compressed and inserted into position though the tip of this thin catheter. This approach avoids the need for opening the chest or using a heart lung machine.

Who is a candidate for TAVI ?
Standard surgical aortic valve replacement continues to be associated with high-quality outcomes and remains the gold standard for treatment of severe aortic stenosis. However, percutaneous and catheter based procedures are available for patients who are not candidates for surgical replacement.

Candidates for this percutaneous procedure include patients with severe symptomatic aortic stenosis and are deemed inoperable by a heart surgeon. “Inoperability” has no single definition but most commonly it is defined as a patient who faces more than a 50% risk of death or severe morbidity following a standard, surgical aortic valve replacement.

Candidates typically have one or more of the following characteristics:

-> advanced age
-> previous heart surgery
-> COPD
-> diabetes
-> home oxygen dependence
-> pulmonary hypertension
-> previous radiation to the chest
-> a severely calcified aorta (aka a porcelain aorta), extreme frailty.

What are the potential benefits of TAVI?
In patients with severe symptomatic aortic stenosis who are not candidates for surgery, TAVI (aka TAVR) is associated significantly improved survival, improved symptoms, and improved quality of life compared to standard treatment. In fact, patients undergoing TAVI were nearly twice as likely to be alive at 1 year compared with those who did not.

What information is needed before you can undergo the procedure?
Evaluation includes assessment of the aortic valve, peripheral vasculature, aortic calcification, coronary disease, hemodynamics, cardiac function, lung function, and frailty.