TAVR is a Boon for Patients with Critical Heart Valve-Related Conditions - says experts at Manipal Hospital Sarjapur

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 In the field of Cardiac science, a relatively new but safe and successful non-surgical technique (TAVI/TAVR) is advocated, giving new hope for life to patients with specific heart-valve-related conditions. Patients who have Aortic Stenosis, meaning narrowed aortic valves can be benefitted from this procedure. The aortic valve is one of the four valves in the heart and lies in the left ventricle, which is responsible for transferring oxygenated blood to the body. Aortic Stenosis occurs when there is calcium or cholesterol build-up in the valve inside the heart impairing its function. This results in limited blood flow to the other parts of the body. There are two methods to treat this condition – either open heart surgery or the revolutionary TAVI/TAVR – a painless, safer, and scarless technique. TAVI/TAVR is a great alternative for elderly patients and patients who are at high risk for open heart surgery.This is what was the highlight of the press conference organized by Manipal Hospital Sarjapur. Renowned cardiologist Dr. Suraj Narasimhan A, Consultant - Interventional Cardiologist & Head of Structural Intervention who performed these complex TAVI and who heads the percutaneous heart valve therapy along with Dr. Saikat Kanjilal, Consultant - Interventional Cardiologist, and Dr. Joseph Xavier, Senior Consultant - Chief of Cardio Thoracic & Vascular Surgery , Manipal Hospital Sarjapur , discussed three complex Aortic valve replacement procedures on elderly patients using this ground-breaking, minimally invasive technique TAVI/TAVR.

The non-surgical medical procedure involves inserting a new valve into the heart using a catheter through a tiny incision in the leg. It is similar to an angiogram and is of low risk for patients, unlike conventional open heart surgery, which involves a greater risk of mortality along with a longer hospital stay.

Dr. Suraj Narasimhan A, Interventional Cardiologist & Head of Structural Intervention, Manipal Hospital Sarjapur, said, " Aortic valve stenosis ispredominantly a disease affecting older patients, and a large proportion of them aredeemed unfit for open surgery. Transcatheter Aortic Valve Implantation is a non-invasive procedure through which the diseased aortic valve of the patient is replaced with a new valve without the need for open-heart surgery. The procedure is carried out usually via a small incision in the artery supplying the leg, through which a wire is inserted into the diseased valve, and a new valve is loaded and implanted at the precise position over the diseased native valve. The newly implanted well-functioning valve replaces the older diseased and narrowed valve, resulting in improved blood flow throughout the body. When compared to open surgery, this procedure is safer, painless, and scarless, especially for older and sicker aortic valve disease patients."

Patients with Aortic Stenosis experience breathlessness, chest pain, fatigue, and dizziness. An irregular heart sound/palpitation is observed among these patients with clinical examination. Dr. Suraj Narasimhan who heads the structural valve program and his team had completed three interesting cases of TAVR recently. The first case was of a 79 years old male with breathing difficulty who could barely walk for 200 mts. Dr. Suraj Narasimhan A evaluated and diagnosed him with severe aortic valve stenosis. His heart pumping was reduced to 25% at the time of evaluation, and his kidney function was reduced as well. Due to his age and comorbidity, he was advised the TAVI technique to replace the diseased valve. Through a 6 mm hole in the leg, Dr. Suraj Narasimhan and his team successfully implanted the new valve. The patient was discharged home without any complications.

The 2^nd case involved an 89-year-old female who suffered heart failure & difficulty breathing. She had severe Aortic stenosis along with calcified blockage in the artery supplying the heart and was barely able to breathe without ventilator support. The team headed by Dr. Suraj Narasimhan which included Dr. Saikat Kanjilal successfully implanted a balloon expandible TAVI valve and also used a diamond burr to remove the calcified blockage and implanted a stent in the affected artery at the same time. The patient was discharged after 48 hrs without any complaints. This is one of the few cases in the world where a new valve and diamond burr ablation was done at the same time.

The 3^rd patient was 93 years old male patient with breathing difficulty and severe narrowing of the Aortic valve due to calcium deposits with reduced heart pumping. Dr. Joseph Xavier evaluated the patient and selected him as suitable for TAVI. Dr. Suraj Narasimhan and Dr. Joseph Xavier successfully implanted a self-expanding TAVI Valve. Cerebral protection using a sentinel filter was used to prevent blood clots from entering the brain circulation. The whole procedure was completed within 1 hour. This is the oldest successful TAVI completed in Karnataka and one amongst the oldest patient in India.  

"TAVI/TAVR was the game changer for these elderly patients with comorbidities and allowed them to breathe a sigh of relief," Dr. Suraj Narasimhan said.

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