TAVI to repair heart valves without surgery

TAVI or Transcatheter Aortic Valve Implantation is the treatment of aortic valve stenosis without open heart surgery and without using ECMO. Aortic valve stenosis is caused by atherosclerosis, a calcium buildup on the aortic valve. It is most commonly found in the elderly aged more than 60 years old. As the aortic valve narrows, the left ventricle has to work harder to pump blood out through the valve, and this can result in heart attack in the future. Normally, aortic valve stenosis does not cause symptoms which make patients do not realize that they have it, and when the symptoms appear, it’s already severe which can lead to death.

 

Aortic valve stenosis is related to increasing age and calcium deposit buildup. The problem is on the heart valve on left heart chamber since it works hardest. Also, there is a pressure while pumping blood, the valve open and close tightly to pump the blood out to the body. As we get older, the heart works for longer, it is the reason that calcium build up on aortic valve.

 

In the elderly who visits the doctor to examine the heart, the doctor will listen to their heartbeat, and if there is something wrong, more investigations will be required. However, people with aortic stenosis do not experience noticeable symptoms until the amount of restricted blood flow becomes greatly. The symptoms that can be noticeable include chest discomfort, faint or near fainting and heart attack. If the stenosis is severe, the patient can be able to live for only two years since the heart cannot work as efficiently as before.

 

Traditionally, open-heart surgery is used to repair or replace heart valves but most of the patients are an elderly, recovery and healing is longer. Although the surgery is successful, the procedure is complex; a large cut on the bone is made with the use of ECMO. Instead, TAVI is a procedure that an artificial valve will be implanted into your heart through the artery in the groin. A small incision is made so that the recovery time is faster.

 

In the past, we choose this approach to perform on the patient with high risk on the open surgery. TAVI will be done on patients who cannot undergo the surgery such as older patients, patient who has performed heart surgery before or patients with paralysis who cannot help themselves. The study shows that TAVI treatment provides better outcome than normal surgery with less complications and less death rate. Later TAVI is brought to use among elderly patients whose age more than 70 years old. The result shows the outcome that is as good as heart valve repair but the patient recovers faster with less complications. The death rate is also similar to heart valve repair. TAVI provides good treatment outcome when the heart valve opens fully, heart attack will be disappear immediately. The patient is also not scared of the procedure due to no surgical scar, faster recovery and fewer complications. Nowadays, there is no study showing the treatment result of TAVI for more than 5 years but TAVI is the good and the most suitable procedure as it demonstrate long term outcome up to 20 years.