Heart Valve Disease
In Aortic Stenosis (AS) or Aortic regurgitation, the aortic valve doesn’t open or close completely, restricting the flow of blood from the left ventricle of the heart to the aorta and the rest of the body or leakage of blood back into the left ventricle. Aortic valve is present between the left ventricle of heart and aorta (the largest artery in the body). The main function of the aortic valve is to open and close and allow blood to flow from the left ventricle to the aorta through which oxygen-rich blood is supplied to the entire body and the coronary arteries.
Symptoms
Symptoms vary from mild to severe and are normally developed during severe disease of the valve. Some people may not experience symptoms for several years.
Mainly the symptoms are breathing difficulty, chest pain on walking, giddiness and palpitations( feeling of own heartbeats).
If left untreated, Aortic Valve disease will weaken the heart and may cause heart failure. Thus, timely treatment will prevent fatality and improve quality of life.
In case the patient is asymptomatic or experiencing mild symptoms, the doctor may recommend regular monitoring of the patient’s condition through periodic follow-ups.
The doctor may advise some healthy lifestyle habits and prescribe medications to prevent complications or worsening of the present condition. It is important to note that medicines can be of help only if the disease is diagnosed in the initial stages without any major visible symptoms.
What is TAVR or TAVI?
A new valve is inserted during this minimally invasive procedure without removing the old, damaged valve. The replacement valve is inserted into the diseased valve. The procedure is called as Transcatheter aortic valve replacement (TAVR) or sometimes as transcatheter aortic valve implantation (TAVI).
How does Valve-within-valve work?
The TAVR approach, which is similar to inserting a stent into an artery, delivers a fully collapsible replacement valve to the valve site using a catheter. When the new valve expands, it pushes the old valve leaflets out of the way of blood flow, and the replaced valve's tissue takes over the job of regulating blood flow.
How is TAVR different from standard valve replacement?
TAVR is performed using smaller incisions in the groin area and a thin catheter to reach the heart, as opposed to standard valve replacement where a long incision is made to separate the sternum and to have direct access to the heart.
What is TAVR procedure?
Valve replacement usually requires an open heart surgery in which the surgically chest is opened(sternotomy) for the procedure. The TAVI or TAVR procedures can be performed through very small openings, allowing all of the chest bones to remain in place.
While TAVR is not without risks, it offers beneficial treatment options to people who might not have considered valve replacement. In terms of recovery, patient's experience with a TAVR may be similar to that of a coronary angiogram. When compared to surgical valve replacement, you will most likely spend less time in the hospital after TAVR.
The TAVR procedure is carried out in one of two ways, allowing the cardiologist or surgeon to select the method that provides the best and safest access to the valve:
- The transfemoral approach in which surgical incision is not required and involves directly entering through the femoral artery (large artery in the groin).
- Minimally invasive surgical approach which involves small incision in the chest is made to enter through a large artery in the chest or the tip(apex) of the ventricle.
Who is a good candidate for transaortic valve replacement surgery?
Patients of all the risk levels can undergo the procedure. TAVR can be an effective option for improving quality of life in patients who would otherwise have few options for aortic valve repair.
Advantages of TAVI (TAVR):
- Shorter hospital stay.
- No surgical scar on the chest wall.
- Quick recovery.
- Does not require general anesthesia.
- Early resumption of professional work.
- Significantly improved quality of life.
