What is Transcatheter Aortic Valve Replacement: Overview, Benefits, and Expected Results
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Transcatheter Aortic Valve Replacement (TAVR) is a medical technology that offers a minimally invasive approach to replacing a faulty aortic valve with an artificial one. The procedure involves the insertion of a replacement valve through a catheter or a small incision in the chest. TAVR is most commonly used to treat aortic stenosis, a condition in which the aortic valve does not open properly and has a reduced diameter, leading to insufficient blood flow.
With the development of TAVR technology, it is now possible to replace the aortic valve without requiring the patient to undergo open-heart surgery. The procedure is less invasive, meaning it requires less risk and allows patients to recover faster with fewer complications. TAVR is widely used to treat aortic stenosis in patients who are at high risk for open-heart surgery, such as those with weakened heart muscles, weakened lungs, diabetes, obesity, or renal failure. The procedure can also be used in people with an artificial heart valve, known as a bioprosthetic valve, who need to be re-operated on.
### Overview of Transcatheter Aortic Valve Replacement (TAVR)
TAVR relies on advances in medical imaging and catheter technology to stop or slow valve leakage. It is a procedure that is done using a catheter (a thin tube) to deliver an artificial valve into the body from the groin area. Prior to the procedure, a specialized imaging technique such as echocardiography or computed tomography (CT) is used to take images of the patient’s anatomy. Once these images have been taken, the physician or surgeon can use an imaging system, such as fluoroscopy, to guide the catheter through the patient’s blood vessels.
Once the catheter is in the correct position, an artificial aortic valve is inserted into the body through the catheter. The patient is then kept still while the medical team monitors the pressure and flow of the new valve. The doctor then decides when to remove the catheter and artificial valve and place the new valve in the correct position.
### Benefits of Transcatheter Aortic Valve Replacement (TAVR)
Transcatheter Aortic Valve Replacement (TAVR) offers many benefits to patients when compared to traditional open-heart surgery. The procedure is often less invasive, meaning it requires less risk and allows patients to recover faster with fewer complications. TAVR is also safer for many patients, particularly those who are at high risk of complications with open-heart surgery. In addition, TAVR may reduce the hospitalization time and speed up the patient’s recovery.
Furthermore, advances in imaging technology have led to better accuracy when positioning the catheter in the body. This has helped to reduce the procedure’s morbidity and mortality rates. TAVR can also reduce the need for medications for high blood pressure and diabetes, as well as the need to undergo other invasive procedures following the surgery.
### Expected Results of Transcatheter Aortic Valve Replacement (TAVR)
The expected results of TAVR are usually improved heart function and increased patient wellbeing. In most cases, patients with aortic stenosis experience symptoms such as breathlessness, chest pain, dizziness, and fatigue. After the procedure, these symptoms are typically reduced and patients often experience overall improved health.
It is important to note that while TAVR is highly effective, complications may still occur. Most complications are minor and can often be attributed to the individual patient’s health or the procedure itself. In rare cases, more serious complications may arise, such as stroke, organ damage, or death.
The patient’s doctor can evaluate the risks associated with the procedure prior to the procedure. In addition, patients can take several steps to reduce their risk of complications following TAVR, such as quitting smoking and following any exercise or diet instructions given to them by their doctor.
### Conclusion
Transcatheter Aortic Valve Replacement (TAVR) is a medical technology that offers a minimally invasive approach to replacing a faulty aortic valve with an artificial one. The procedure is often less invasive, meaning it requires less risk and allows patients to recover faster with fewer complications. TAVR may reduce the need for medications for high blood pressure and diabetes, as well as the need to undergo other invasive procedures following the surgery. The expected results of TAVR are usually improved heart function and increased patient wellbeing. Potential complications of TAVR include stroke, organ damage, and death, but these risks can be greatly reduced by taking precautions such as quitting smoking and following exercise and diet instructions. TAVR is an effective procedure, and patients should discuss the risks and benefits of this procedure with their doctor prior to undergoing the procedure.
Overview and Benefits
Transcatheter aortic valve replacement (TAVR) is a procedure used to treat a narrowed aortic valve. The aortic valve is one of the four valves of the human heart. It has three leaflets. These leaflets are opened to allow blood to push forward when the left ventricle contracts. They close between heartbeats to prevent the blood from flowing backward.
The aortic valve can become narrowed, thickened, and less flexible as a person gets older. When this happens, the valve will not fully open each time the ventricle contracts. As a result, the heart is forced to work harder in order to push blood through. Over time, this can strain the heart. This results in a number of symptoms. These include chest pains, shortness of breath, and dizziness. When not treated promptly, the condition can progress. It can cause the heart to fail. This is a life-threatening condition.
The condition is treated by replacing the diseased aortic valve. This procedure is often performed via open-heart surgery. This method requires an incision in the chest cavity to access and replace the diseased valve. TAVR is an option to open-heart surgery. It is less invasive and only requires small incisions. However, not all patients qualify for it. Patients who are eligible for this procedure are those who are not well enough to withstand open-heart surgery. It can also be an option for patients with certain medical conditions.
Who Should Undergo and Expected Results
Many patients with a narrowed aortic valve prefer TAVR over open-heart surgery. This is because it minimises the many risks of open-heart surgery. However, TAVR is only an option for those who meet certain criteria. These include extremely elderly patients (80 years and older) and those who are not physically strong enough to undergo open-heart surgery.
Before TAVR is even recommended, patients are assessed by a multidisciplinary team of specialists to determine their eligibility.
It is important to note that not all patients with a stenotic aortic valve have to undergo a surgical procedure. Those with mild to moderate cases and do not show symptoms of the condition may not require treatment. The progression of the disease can be delayed in most cases by living a healthy lifestyle.
The procedure can restore normal blood flow to the heart. Because of this, patients are relieved of their symptoms. Their quality of life is also expected to improve significantly. In addition, their risk of heart failure will be greatly minimised.
How is the Procedure Performed?
There are two methods on how TAVR is performed. Their main difference is the location of the incision. The incision can be made in the groin (transfemoral approach) or chest area (transapical approach).
Transfemoral means passing through the femoral artery. This artery can be accessed through the groin. In this procedure, the surgeon creates an opening in the groin and inserts an introducer sheath into the femoral artery. A flexible guidewire is then inserted through the sheath and advanced to the aorta and the left ventricle. The guidewire is then used to pass a catheter through the aortic valve. This catheter has a small balloon on its tip. When inflated, this balloon can make the aortic valve wider. Another catheter is then used to place the replacement valve. A stent is used to support the valve.
The second method is called transapical approach. It requires an incision in the chest (between the ribs) to access the lowest part of the heart. It then follows the same steps explained above. Both approaches are carried out under general anaesthesia. Both also use a special type of x-ray that surgeons use as their guide throughout the procedure. During the surgery, the patient’s surgical team closely monitors their heart function and rhythm. Any changes in heart function are managed as needed during the procedure. After the surgery, the incisions are closed with stitches. Patients are then given antibiotics to prevent infection from occurring.
Patients are then transferred to the hospital’s intensive care unit. They are closely monitored for possible complications. Many patients stay in the hospital between three and five days.
It is important for patients to adopt a healthy lifestyle following surgery. They are advised to watch what they eat. They must also do certain exercises approved by their doctor on a regular basis. They are also advised against smoking and drinking too much alcohol. It is also important that they maintain a healthy weight.
Potential Risks and Complications
Although less invasive than open-heart surgery, TAVR has risks of complications. These include damage to blood vessels and severe bleeding. The list of possible risks also includes stroke and heart attack. Patients may also develop arrhythmias, infections, and kidney disease. In most severe cases, it can cause death.
References:
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Nishimura RA, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. The Journal of Thoracic and Cardiovascular Surgery. 2014;148:e1.
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Mack MJ, et al. 5-year outcomes of transcatheter aortic valve replacement or surgical aortic valve replacement for high surgical risk patients with aortic stenosis (PARTNER 1): A randomised controlled trial. The Lancet. 2015;385:2477.
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Very informative article! #ValveReplacement
#TranscatheterValveReplacement