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Transcatheter Aortic Valve Replacement (also known as Transcatheter Aortic Valve Implantation) is a procedure that fixes a narrowed or damaged aortic valve without the need for open-heart surgery. It is a method recommended to the patients suffering with severe aortic valve stenosis or narrowing of the aortic valve.

At the CARE hospitals in Hyderabad, we have highly experienced interventional cardiologists in performing various cardiac procedures and expert cardiac surgeons who provide high-quality TAVI/TAVR procedures using the latest technology, allowing patients to experience better heart function, quick recovery time, and shorter hospital duration.

What is TAVI/TAVR?

TAVI / TAVR is a minimally invasive heart valve replacement procedure that people are being recommended to treat aortic stenosis, a condition where the aortic valve becomes narrowed, thickened or stiffened due to calcium deposits. The aortic valve normally helps control blood flow from the heart’s left ventricle into the aorta, and the aorta carries oxygen rich blood around the whole body. When that valve does not open well, the heart ends up pushing harder to move blood, and that usually brings symptoms along with serious complications.

During the TAVI/TAVR procedure, doctors take out the damaged valve and swap in a new artificial valve, using a thin catheter, inserted through a blood vessel, often through the groin or the chest area.

Why TAVI/TAVR?

Advantages of the TAVI/TAVR procedure over the traditional surgery procedure are the following:

  • Less Invasive Procedure: This procedure is performed through small incisions rather than a big cut in the chest. 
  • Quick Healing Time: People tend to heal much faster after having this treatment done.
  • Shorter Hospitalization Period: It takes less time in the hospital for most people undergoing this procedure.
  • Low Post-operative Pain: There is minimal chest cutting; thus, the risk of experiencing post-surgical pains is low.
  • Ideal for Risky Candidates: Those suffering from other diseases and the old age category benefit more from this procedure.
  • Proper Blood Flow Restoration: Blood flow from the heart to other body parts is restored using this valve procedure.
  • High Levels of Relief: Many symptoms such as shortness of breath, chest pains, and fatigue are greatly relieved using the procedure. 

When is TAVI/TAVR Recommended?

A cardiologist may recommend TAVI/TAVR if a patient has:

  • Severe Aortic Stenosis: This is the condition where the aortic valve becomes narrowed resulting in decreased blood flow from the heart to the body. If this condition is left untreated, it could cause some complicated issues.
  • Chest Pain from Valve Narrowing: If the aortic valve is narrowed, the heart has to work harder to pump blood around. This struggle can cut-off the heart itself of oxygen, causing chest pain or discomfort, especially when a person is active.
  • Shortness of Breath When Active or Even Sitting Still: Patients may have to gasp for air when they are active or, in more severe situations, even sitting still. This is because the blocked valve makes it extremely difficult to get the oxygen-rich blood.
  • Episodes of Fainting Because of Aortic Stenosis: Aortic stenosis causes decreased blood flow to the brain, particularly with exertion, and results in dizziness, lightheadedness, or fainting all of which should prompt immediate medical evaluation.
  • Fatigue from Decreased Blood Flow: You may also experience fatigue and weakness (compared to your baseline) because of the heart's inability to effectively pump blood to the body. Chronic fatigue can dramatically affect your daily life and lead to a significant decline in the quality of life.
  • Symptoms Associated with Heart Failure Related to Valvular Disease: If you have severe stenosis of the heart valves, it puts an increased burden on the heart and can potentially lead to heart failure. Common heart failure symptoms associated with valvular heart disease include: leg swelling, shortness of breath or difficulty breathing, and fluid retention. TAVI/TAVR can restore this normal valve function and may improve heart failure symptoms.
  • Higher Surgical Complications Risk With Surgical Valve Replacement: If you are older or have comorbid conditions, such as diabetes, chronic kidney disease or lung disease, you have an increased risk of complications from standard open heart surgery. TAVI/TAVR is a less invasive approach to treatment and gives the patient a more rapid recovery versus traditional open heart surgery, with less surgical stress placed on the patient.

The decision to perform TAVI/TAVR is made after a comprehensive evaluation of the patient's age, overall health, heart function, and severity of aortic valve disease. A multidisciplinary heart team carefully determines the most appropriate treatment approach for each patient. 

How is TAVI/TAVR Performed?

Most TAVI/TAVR procedures are done using either sedative medications with local anesthetics or general anesthetics.

  • Prior to the Procedure: Before proceeding with TAVI/TAVR, patients need to be evaluated for potential inclusion based on their individual conditions. During this process, the cardiology team will recommend many tests (including echocardiography, computerized tomographic/CT scan, blood tests, electrocardiogram/ECG, and coronary angiography) in order to evaluate how well the heart functions and what the shape and size of the heart valves are.
  • During the Procedure: The surgery will involve the insertion of a thin tube through an artery, typically from the groin. The thin tube will be guided to the heart and then to the damaged heart valve that is located on the aorta (the large blood duct that carries blood to the body). A new heart valve constructed from living tissue (that is similar to the original heart valve) will be inserted into the previously replaced heart valve. Once the new heart valve is inserted, it will immediately begin to produce blood flow in both parts of the body. Finally, the thin tube will be carefully removed.
  • After the Procedure: After this TAVI procedure, patients are kept under watch 24/7, either in the recovery room or in the ICU, for a few days to see how their heart is doing and to recover fully. You will be continuously monitored for the first few days for your heart rhythm, blood pressure, vital signs and general condition.
  • Recovery After TAVI/TAVR: Typically, recovery after TAVI or TAVR is faster than after open-heart surgery. Patients usually feel just mild discomfort where the catheter went in, get hit with some temporary fatigue, and slowly see improvements in breathing and energy levels. Doctors will advise them to:
    • Stick to their prescribed medications
    • Stay clear of strenuous activities for a while
    • Keep showing up for those follow-up visits
    • Adopt a heart-healthy lifestyle
    • Watch for infections or unusual symptoms
    • By a few weeks post-op, most people are back to their usual routine.

Risks and Complications of TAVI/TAVR

TAVI/TAVR is a safe and effective treatment when conducted by expert hands. However, like any medical treatment, there may be certain possible risks, including:

  • Bleeding: Bleeding may occur at the site of the catheter insertion or internally, rarely, during or after the surgery. Most cases can be handled with proper medical attention.
  • Blood Vessel Injury: There is a tiny chance of damaging the walls of the blood vessels, while the catheter is passed through the blood vessels. Advanced imaging and the experience of professionals can decrease this risk.
  • Stroke: A stroke is a very rare complication where tiny particles might end up in the brain during the procedure. But careful planning can really cut down on that likelihood.
  • Irregular Heartbeats: These can show up in some patients afterwards—many times, these clear up fast, though some people might need extra monitoring or care. Some individuals may have abnormal cardiac rhythms after TAVI/TAVR. They are normally transitory but sometimes require watching or treatment.
  • Valve Leak: A little amount of blood can leak around the new valve. This is called a paravalvular leak. Most leaks are small and don’t greatly damage the valve’s performance.
  • Infection: Like any other medical procedure, there is a chance of infection, either right where the catheter goes in or deeper inside the body. Using sterile techniques properly, plus good aftercare, usually helps limit these problems.
  • Kidney-related Complications: The contrast dye that’s used during the procedure can sometimes have an effect on kidney function, especially if someone already has kidney disease beforehand. It’s not common, but it can happen.
  • Need for a Pacemaker Placement: a few patients might end up with electrical conduction disturbances after the valve is implanted, and then they may need a permanent pacemaker so the heartbeat stays steady and regular.
  • Rare Valve Movement or Malfunction: on the uncommon side, the replacement valve can move away from its intended position, or it may not behave the way doctors expect. In those cases, more medical treatment might be necessary, sometimes sooner rather than later.

Timely follow-ups and consultations post-procedure can help reduce these risks significantly.

Why Choose CARE Hospitals for TAVI/TAVR?

Choosing CARE Hospitals gives you the best cardiac care and also provides you the advanced cardiac treatments in Hyderabad. We have:

  • Experienced Cardiology Team: Our cardiology department has highly experienced interventional cardiologists and cardiac surgeons who have expertise in various complex and advanced procedures.
  • Advanced Technology: We are equipped with modern catheterization laboratories and advanced imaging systems for accurate & precision-based treatment.
  • Minimally Invasive Cardiac Procedures: We are focused on faster recovery of the patient and shorter stay in the hospital by using advanced techniques with minimum pain and quick recovery.
  • Personalized Treatment Plans: Treatment plans will be designed based on the undergoing procedures and the patient’s health condition.
  • Comprehensive Cardiac Care: Complete support through diagnosis , recovery and ongoing long term check ins, with a sort of steady follow up afterward.  
  • High Success Rates: Excellent clinical results with patient centered attention and advanced treatment methods.

How to Maintain Heart Health After TAVI/TAVR

The following recommendations can help patients achieve improved long-term heart health:

  • Take medication as prescribed: Every medication prescribed by your physician will benefit your heart health if taken as directed.
  • Maintain healthy eating habits: Low sodium, low saturated fat, and limited processed food all will be beneficial to heart health long-term.
  • Regular exercise: Exercising regularly will place you in a state where there will be an increase in overall health and strengthen the heart.
  • Avoid smoking / drinking too much alcohol: Smoking & drinking too much alcohol will cause you to not heal as fast as you should when recovering from heart disease.
  • Go to all follow-up appointments: Staying current with routine check-ups provides excellent monitoring of your heart health/functionality. This includes all components of your heart, such as valves.
  • Consider other disease management: Keeping control over your diabetes and achieving healthy blood pressure/cholesterol levels can positively impact heart health long-term.
  • Control your body weight: Being a healthy weight will place less stress on your heart.

Conclusion

The technique of TAVI/TAVR is extremely effective for severe cases of aortic valve stenosis. The treatment aids in restoring proper circulation, alleviating symptoms, and increasing the patient’s quality of life without resorting to more complicated surgery. CARE Hospitals in Hyderabad offers the best TAVI/TAVR surgery that is state-of-the-art and performed by our expert cardiologists.

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