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What is Aortic Valve?

The heart consists of two sets of pumping chambers: the chambers on the right side pump blood to the lungs. The chambers on the left side pump blood to the rest of the body. The main pumping chambers of the heart are called the ventricles. The ventricle being a pump has both, an inflow valve and an outflow valve. The aortic valve is an outflow valve and is on the left side of the heart.

What is Aortic Valve Stenosis?

Aortic Valve Stenosis or Aortic Stenosis occurs when the heart`s aortic valve narrows. The aortic valve allows blood to flow from the heart to the body. Stenosis prevents the valve from opening efficiently, forcing the heart to work harder than usual, to pump blood. This causes pressure to build-up in the left ventricle, which thickens the heart muscle.

Your heart can make up for Aortic Valve Stenosis and the extra pressure for a while. But at some point, it won`t be able to keep up with the extra effort required to pump blood through the narrowed valve. This can lead to heart failure.

Diagnosis of Aortic Stenosis

Most people find out they are suffering from Aortic Stenosis when their doctor hears their heart murmur, during a regular physical examination. Medical history of the patient, clinical examinations and simple imaging tests like Echocardiography can be used to diagnose Aortic Stenosis. Before valve replacement therapy can be performed, undergoing Multi-slice CT scans and Cardiac Catheterization (Angioplasty) are required.

These tests, and others, help your doctor to determine how narrow or tight your aortic valve may be and how well your heart is pumping. Once Aortic Stenosis is discovered, your doctor will either recommend treatment or suggest careful monitoring.

Patients, who are unable to undergo valve replacement, through an open heart surgery, may be recommended Transcatheter Aortic Valve Replacement (TAVR) as an alternative procedure by their doctor.

What is TAVR or TAVI?

Transcatheter Aortic Valve Replacement (TAVR) or Transcatheter Aortic Valve Implantation (TAVI) is a minimally invasive surgical procedure, which repairs the valve without removing the damaged valve.

Instead, a replacement valve is lodged into the place of the aortic valves. This procedure is for people who have been diagnosed with severe Aortic Stenosis and are considered either high-risk or too sick for surgical valve replacement.

What are the potential benefits of TAVR?

The potential benefits of TAVR :

  • Shorter recovery time
  • Minimally invasive
  • Significantly less pain than open heart surgery
  • Requires a small dose of anaesthesia
  • Short hospital stay
  • Life-saving option for high-risk patients
  • High success rate

What causes Aortic Valve Stenosis?

Aortic Valve Stenosis is caused by:

  • Calcium build-up on the aortic valve. As you age, calcium can build up on the valve, making it rigid and thick
  • A heart defect you were born with (congenital)
  • Rheumatic fever - this can damage the valve

What are the symptoms of Aortic Stenosis?

Aortic Valve Stenosis is a slow process. For many years you may not experience any symptoms. But at some point, the valve is likely to become so narrow, that you may start having problems. Symptoms are often brought on by exercise, when the heart has to work harder.

As Aortic Valve Stenosis gets worse, you may have symptoms such as:

  • Chest pain or pressure (angina). You may have a heavy, tight feeling in your chest
  • Feeling dizzy or faint
  • Feeling tired and being short of breath
  • A feeling that your heart is pounding, racing, or beating unevenly (palpitations)

If you start to notice any of these symptoms, let your doctor know right away as you may need treatment.

Who is an ideal candidate for TAVR?

Patients with a severe case of Aortic Stenosis, who cannot be operated upon, or have a high risk of complications from surgery are normally recommended for TAVR.

High risks can arise from:

  • Ageing
  • Previous heart surgeries
  • Severe lung diseases
  • Diabetes
  • Kidney failure
  • Supplemental oxygen dependence
  • Pulmonary hypertension
  • Severely calcified aorta (Porcelain Aorta)

How is TAVR performed?

TAVR procedure can be done through very small incisions. A patient undergoing TAVR requires short hospital stay (on an average 3 to 5 days).

The TAVR procedure is performed using one of the following approaches, allowing the cardiologist or surgeon to choose which one provides the best and safest way to access the valve:

  • Entering through the femoral artery (large artery in the groin), called the Transfemoral approach, which does not require a surgical incision in the chest
  • Using a minimally invasive surgical approach, with a small incision in the chest, and entering through a large artery in the chest or through the tip of the left ventricle (the apex), which is known as the Transapical approach

What does Pre-TAVR work-up involve?

Pre-TAVR work-up involves clinical examination of the patient by heart specialists. Following tests must also be performed as a standard:

  • Echocardiography is used to confirm the severity of Aortic Stenosis, Aortic Valve Anatomy and extent of calcification
  • CT Angiography of the aortic root is used to determine the optimal image orientation for valve positioning
  • Left and right cardiac catheterization is used to evaluate concomitant coronary artery disease or pulmonary hypertension that may require treatment prior to TAVR
  • CT Angiography of the Thoracoabdominal and Iliofemoral arteries is used to evaluate the diameter of the vessels and calcification, and to plan for the access site

What sets TAVR at BLK Heart Centre apart from the rest?

From diagnosis to the treatment of Aortic Valve Stenosis, we offer our patients access to the most advanced cardiac care in North India- through cutting edge technology, latest breakthroughs in medicine and procedures, a highly dedicated multidisciplinary team of heart specialists and medical staff, who are experts in treating a wide range of heart diseases.

At BLK Heart Centre, our cardiac patients have experienced superior outcomes to their heart problems not only because of the most advanced treatment available, but also because of our Heart Team`s expertise in utilising the latest technology to identify and deliver the right treatment to every patient, with professionalism, sensitivity and compassion.

passion for healing...