“MEAT RETAILING ON A DYNAMIC PHENOMENA”
March 21, 2023
March 26, 2023,4:49:32 PM
An 83-year-old patient in Jammu was in a critical state with ongoing severe breathlessness and was found to have low BP (cardiogenic shock) and acute heart failure with a critically narrowed aortic valve and very low heart pumping capacity. In view of the critically narrowed aortic valve and the ongoing critical condition of the patient, a heart team meeting was held, and everyone was of the opinion that the patient needs urgent aortic valve replacement to save his life, but open-heart surgery would be very risky for such a patient.
Dr Prashant Dwivedi saw the patient, met with his family, and then performed a Transcatheter aortic valve implantation for the patient. The patient responded remarkably well to this therapy, and by the next morning, he had started walking and came out from the ICU, and after two days, he was discharged to go home walking with significant improvement in his heart's functioning.
In daily lives, people encounter others in their immediate circle who have been diagnosed with heart disease; some are managed medically, while others require intervention or surgery, depending on the disease and its complexity. Generally, a cardiac-related disease could be related to the structure of the heart, creating functional difficulties in the heart, or it could be related to the coronary arteries (the vessels that supply blood to the heart for its functioning), or it could also be related to the rhythm (electrical system) disturbances of the heart.
Whether the patient is experiencing symptoms or not, treatment is a must for severe aortic stenosis. Until a few years ago, the primary treatment option for patients with aortic stenosis was surgical aortic valve replacement (SAVR), which was carried out by making a large incision on the patient’s chest. This allows the surgeons to access the diseased aortic valve, which is then removed and replaced with a new prosthetic valve. But almost 30% of the patients are not eligible for surgery owing to multiple conditions. For these patients, the TAVR/TAVI (transcatheter aortic valve replacement) technique has proved to be a boon.
TAVR, or transcatheter aortic valve replacement, is a minimally invasive procedure that uses cardiac catheterization techniques to replace the damaged valve. TAVR can help restore blood flow and reduce the signs and symptoms of aortic valve stenosis. Unlike surgical aortic valve replacement, which requires general anaesthesia and a long incision down the chest (open-heart surgery), TAVR is done using smaller incisions and a thin, flexible tube (catheter) to reach the heart. To perform TAVR, a very small incision is made in the groin area, and a compressed valve is inserted through a catheter into the heart. Moving X-ray images or echocardiogram pictures help place the catheter in the correct position.
In the last 15 years with the help of newer innovations, rapidly evolving newer technologies, dedicated training, and expertise; now not only the aortic valve but also the other three heart valves (mitral, pulmonary, and tricuspid valve) can also be replaced by transcatheter technique. Millions of patients worldwide who were previously deemed unfit or at high risk for open heart surgery have been benefited from new transcatheter-based therapy for valve problems. This therapy brought new hope for these patients as it allows them to get a minimally invasive procedure without general anaesthesia, without a scar, with no major compromise in lifestyle, and with a faster recovery than surgery.
Under the leadership of Dr. Samin K. Sharma & Dr Ajeet Bana, the Structural Heart Team at Eternal Hospital has achieved many milestones and making it a preferred destination for complete heart care and treatment.
Dr. Prashant Dwivedi, In-charge TAVR & structural heart program at Eternal (EHCC) Hospital, Jaipur is one of the very few interventional structural cardiologists in India who has been dedicatedly trained in complex coronary and structural interventions, including TAVR, TMVR, Mitra Clip, left atrial appendage device closure, and other complex structural heart interventions.