Heart valve replaced using catheter

Jeyaseeli, 80, was going through a lot. A cardiac patient, she had difficulty in walking and breathing. Things got worse in February this year, when she suffered a cardiac arrest during a hospital review. She was revived, but doctors ruled out surgery because of age and certain other factors.

Months later, her son, Roche Antony, a resident of Karur, is amazed at her recovery. “She suffered from aortic stenosis, which is basically a narrowing of the aortic valve. She found it difficult to take even five to 10 steps. But now, she leads a normal life. She is hale and healthy,” he said.

TAVI procedure

It was a non-surgical option for treating aortic stenosis — Transcathether Aortic Valve Implantation (TAVI) — that came to her help. The octogenarian underwent the procedure on March 1 and returned home after two to three days of hospitalisation.

Dr. Sai Satish, senior interventional cardiologist, Apollo Hospitals, who performed the procedure, said: “More than one million cases of aortic stenosis are diagnosed every year in India. Half of them are due to age-related narrowing of the aortic valve. Age-related degeneration of aortic valve is emerging as the most common cause of aortic stenosis.”

He pointed out that recent studies have shown one in 10 persons aged 75 and above is affected with the condition. It is here that TAVI serves as an option for the elderly.

Training programmes

Dr. Satish, who has done complex coronary procedures, is among the few persons licensed to implant the valves independently in India. His first exposure to TAVI was in 2008 in the Netherlands. Since then, he has conducted training programmes in India and abroad, and several live demonstrations.

Till recently, treatment options available included Balloon Valvuloplasty, Surgical Aortic Valve Replacement and medical management, he said.

In TAVI, a thin, flexible tube (catheter) housing the collapsed valve is inserted most commonly through an artery in the leg (transfemoral approach) and delivered to the heart. Similar to coronary artery stenting methods, the procedure is performed in a cardiac cath lab, he explained.

“The valve delivery system is used to position the new valve that is then implanted inside the diseased aortic valve. The recovery is usually dramatic because their hearts are now able to pump the right amount of blood to the entire body. TAVI usually requires hospitalisation for three days to a week,” he said.

‘Extremely important’

He has an advice for patients though. “Once severe symptomatic aortic stenosis is diagnosed, nine out of 10 patients, who do not receive some form of intervention, will die within four years. It is extremely important to get professional help for valvular heart disease.”

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