A Good Option for the Heart
Everything you need to know about TAVR
TAVR (Transcatheter Aortic Valve Replacement), also known as TAVI,
is a valve-replacement procedure for the aortic valve. The narrowing
of the aortic valve is known as Aortic Stenosis. The causes of Aortic
Stenosis could be various including birth defect, rheumatic fever,
radiation therapy and increased calcium deposits. Due to the stenosis,
there is reduced blood flow to the rest of the body and it affects the
pressure in the left atrium. It is important to note that most people
don’t feel the symptoms of Aortic Stenosis until the restricted blood
flow has been significant. Symptoms include breathlessness, chest
pain, blackouts and heart murmur.
If there are no symptoms along with mild stenosis, the doctor may advise
non-invasive treatments such as medication, long term monitoring,
elimination of extra fluids. If the extent of your Aortic Stenosis is
severe, you may be advised surgery. The two types of surgery are Open
Heart Valve Replacement (surgical valve replacement) and TAVR.
Since TAVR is a newer approach, the long-term benefits are unknown.
Therefore, if you are at a low risk, your doctor may opt for Surgical
TAVR is mostly recommended for those who are at intermediate to
high risk of complications from Surgical Valve Replacement. It is also
recommended for elderly patients as well as for those who have comorbidity
such as kidney disease, diabetes, lung disease. It is also
ideal for those who previously have had Open Heart Surgery or those
whose health has not improved despite medications.
Under general anaesthesia, a balloon catheter equipped with the
replacement valve (porcine or bovine) is inserted either into the femoral
artery near the groin (transfemoral) or into a large artery in the chest
via a small incision (transpacial). The catheter is passed into the heart
and placed at the position of the aortic valve. The balloon is inflated,
to push away the damaged tissue, making room for the new valve. The
new valve expands, sitting inside the damaged valve and the deflated
balloon and catheter is removed.
The advantages of TAVR include, shorter recovery time as the patient
usually gets discharged within 2-3 days post the intervention, reduced
risk of stroke and fatality as compared to Surgical Valve Replacement
in medium-high risk patients and no major incision in the chest. In
TAVR, a heart-lung machine is also not used.