Transcatheter Aortic Valve Replacement (TAVR)
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Case Report - TAVR
Indian Heart Journal - TAVR
TAVI in layman's language - by Dr. Ashok Seth
The revolutionary and pathbreaking procedure of "Percutaneous Transcatheter Aortic Valve Implantation (TAVI): a non surgical, without cardiopulmonary bypass, Cath Lab based heart valve replacement procedure" was performed for the first time in the country, by Dr Ashok Seth, Chairman, Fortis Escorts Heart Institute & his team, on three elderly patients with severe calcified Aortic stenosis (severe restriction of opening of the valve between the heart and rest of the body).
These patients had severe breathlessness, heart failure, which could have resulted in sudden death. The procedure was life saving for these patients. These patients were also extremely high risk for 'Valve Replacement by Surgery which involved opening up of chest and heart and putting patients on cardiopulmonary bypass' as two of them had already undergone previous bypass surgery, were more than 75 years of age, were frail and one lady also had extreme calcification of aortas because of which she could not have a surgical valve replacement. Because of her Severe Aortic Valve stenosis, she had been in severe heart failure necessitating even ventilator in recent past. All three patients for whom this was as life saving procedure have recovered well and walking.
The Valve implantation was performed in the Cath Lab (not the surgical theatre), through the groin in an angioplasty like procedure without opening the chest or putting the patient on bypass. The patients were up and about the next day and talking & eating normally. Each procedure took approximately 2-hours to perform.
Dr Ashok Seth was involved in the very early stage of development of catheter based valve replacement procedure when he performed one of first cases in the World in 2004 when the procedure was performed on a cardiopulmonary bypass with a very large device which had to be inserted surgically.
Aortic stenosis is a life threatening disease of the valves which specifically increases with age and effects the elderly. Surgical valve replacement on cardiopulmonary bypass of these patients can be very high risk because of age and other risk factors like lung disease, kidney disease and previous bypass surgeries etc. It not treated 50% of the patients can die within 1-year.
This procedure would be a boon for such patients to be able to save their lives and continue to live through a relatively safe 'non-surgical TAVI procedure'.
The non-surgical aortic valve replacement was performed using the COREVALVE Revalving System.
WHY CHOOSE FORTIS ESCORTS HEART INSTITUTE FOR TAVR?
Fortis Escorts Heart Institute is the first hospital in India to launch the TAVR programme in 2012 and has the maximum experience of this new technique of valve replacement with an extremely high success rate. A dedicated heart team (consisting of Interventional Cardiologist, Cardiac Surgeon, Non-Invasive Cardiologist, Cardiac Radiologists and the Cardiac Anaesthesiologist) evaluates every patient and jointly performs the procedure. For 25 years, the institute has been a gold standard for clinical excellence and expertise; and continues to be the leader in Cardio-Vascular Sciences. Renowned Cardiologists, Cardiac Surgeons and Clinical Cardiologists come together to provide world-class treatment. The institute has been repeatedly awarded as the best cardiac care provider in the country by various social and public bodies.
Over the past 28 years, Fortis Escorts Heart Institute has conducted more than 1,85,000 Angiographies, 59,000 Angioplasties and 1,00,000 Cardiac Surgeries, one of the highest numbers in the world.