A 78-year-old patient from Odisha’s Paradip underwent a successful heart Aortic valve replacement with TAVR (Transcatheter Aortic Valve Replacement) without open-heart surgery by a team of doctors led by Interventional Cardiologist and structural Heart Disease specialist, Dr J K Padhi, Director, Cardiology, AMRI Hospitals in Bhubaneswar.
The patient was suffering from Severe Aortic stenosis. Due to the heart problem, he was finding difficulty in doing his Daily activities and getting short of breath on minimal exertion. The patient was advised Surgical Aortic valve replacement (SAVR). But due to high risk, surgery was denied and the patient was plan for nonsurgical treatment doing TAVR.
He was also hospitalised for heart failure at his home town. Due to the severe narrowing of the Aortic valve, medicines were not working for his disease, and the only treatment offered was valve replacement. Dr Padhi replaced Aortic valve by performing TAVR, non-surgically at the AMRI Hospitals.
“This transcatheter native Aortic valve replacement now performed worldwide and is the first case in AMRI Hospitals Bhubaneswar. This treatment has brought a new ray of hope for the patient and his family,” said Nilanjana Mukherjee, Vice President and Unit Head, AMRI Hospitals.
“Aortic stenosis refers to the narrowing of the Aortic valve. Aortic valve is the outflow valve that controls the oxygenated blood flow from the heart to the body. Narrowing of Aortic valve creates a life-threatening situation called Aortic stenosis and heart failure,” said Dr. Sidharth Mishra, Medical Superintendent of AMRI Hospitals Bhubaneswar.
The patient was admitted to the hospital with the condition of heart failure, a history of shortness-of-breath, difficulty in walking, and carrying out daily activities. Traditionally, such patients are treated with open-heart surgery.
“Whether TAVR or SAVR is more appropriate for a given individual depends on multiple factors and is discussed with each patient by a heart team comprising of both an interventional cardiologist and a cardiac surgeon. Now-a-days, TAVR is mostly recommended in elderly frail individuals having previous history of heart surgery, brain stroke and comorbid systemic disease involving lungs, liver and kidney. TAVR when compared to surgery is safer in selected patients,” said Dr. J K Padhi, Director, Cardiology, AMRI.
What is TAVR?
Transcatheter Aortic Valve Replacement (TAVR) is a minimally invasive procedure to replace the Aortic Valve in patients with diseased Aortic valve. The development TAVR has emerged as a lifeline for patients considered to be inoperable by open heart surgery also called as surgical Aortic Valve Replacement (SAVR).
How to prepare for TAVR?
The heart team will access the patient’s general condition through various imaging (TVAR CT protocol / Coronary angiography) and blood tests before TAVR surgery, to confirm the condition of the patient’s lungs and heart. The team will also advise a heart ultrasound to the patient to estimate aortic valve.
How TVR Works?
During TAVR, interventional cardiologist inserted a catheter through a small cut in the skin over the blood vessel in the groin to deliver and implant the artificial valve which anchors over the diseased valve. TAVR procedure typically takes less than one hour and usually done under mild sedation or general anaesthesia.
Recommendations for patients post TAVR recovery
After the procedure, the patient is transferred to the intensive care unit (ICU), so as to closely monitor the patient for any redness, swelling or bleeding from the groin site. They are prescribed blood thinners during discharge. Most patients go home the next day and are allowed to resume their normal activities.