Transcatheter aortic valve implantation is a procedure where an aortic valve is implanted with the use of a long narrow tube, known as a catheter. In general, the catheter is inserted into a large blood vessel in the groin or through a small incision which is made in the chest of the patient. Special transcatheter aortic valves are designed for surgical purposes. Natural tissue from the heart of either pig or cow is used for making the valve, which will then be implanted in the patient. Re-engineered, the natural tissue is then attached to a flexible and expandable mesh frame. For implanting the valve to the heart, the valve is squeezed inside or around the catheter. The catheter is then inserted and guided to the location of the aortic valve opening in the heart. After the implantation of the new valve, over the existing valve, the catheter is removed. The working of the new valve starts immediately after implantation
Patients who suffer from progressive heart failure due to aortic stenosis, but are not fit for traditional open-heart aortic valve replacement surgery will need TAVI. Here are some of the conditions in which open-heart surgery might prove to be dangerous:
The surgical and medical team will first ascertain the overall health of the patient. The doctor will carry out various kinds of tests and investigations on the patient to understand better if they will benefit from the TAVI procedure. Some of the tests include blood tests, x-rays, CT scans, electrocardiograms, echocardiogram and so on. With an echocardiogram, it is possible to create images of the heart for evaluating the aortic valve. For some patients, cardiac catheterization might also be done, in order to evaluate the heart. Other preparations, which need to be taken include: Informing the doctor about all the medicines that you take, including over the counter medicines If you smoke, ask the doctor how soon should you quit before the surgery In case the doctor asks you to stop certain medicines, do that as per instruction Don't eat and drink after midnight, before the surgery
After the surgery, the patient is moved to the intensive care unit of the hospital so that they can be monitored all the time during recovery. As the recovery process continues, the various tubes in the arteries and veins are removed gradually. The hospital stay will continue for a few days. But normal diets can be resume quickly. Once the patient is home, which happens after a few days, depending on the speed of recovery, they must follow all the instructions regarding medicines, diet, pain control, activity and wound care. Also, maintain all the follow-up appointments. It might take a few weeks to recover completelyMentioned below are some guidelines, which will help in quick healing:
More and more cardiologists are getting experience with TAVI and the risks associated with the same are decreasing. However, TAVI is a major procedure in which general anesthesia is required. Some of the common risks which are closely associated with TAVI include the following:
There might be other risks as well depending on your health condition. Before the procedure have a detailed discussion with your doctor on these matters. When handled by a good cardiologist and proper following of instructions, patients undergoing TAVI recover quickly.
Transcatheter Mitral Valve Replacement. The mitral valve is important among the four valves in the heart. Just like tricuspid valves, these valves help in controlling blood flow to the ventricles from the atria.
The most common problem that is seen in the mitral valve is degenerative valve disease. This valve ailment is progressive in nature and is a slow degeneration from mitral valve prolapse. This is a condition in which there is improper leaflet movement and almost 4-5 percent of the general population is affected by this problem. Over a long period of time, the attachments of the valve thin out. Sometimes, the valve also ruptures, and the leaflets become redundant and floppy. As a result, there’s leakage through the valves.
Regurgitation happens when blood flows backward in the valves as there might be leaks in the valve leaflets after they are closed. In such a situation, the heart has to work harder to pump a larger volume of blood. In case there is a leaky mitral valve, blood will flow back to the left atrium from the ventricle when there is a contraction in the ventricles.
Stenosis is also a condition, which might affect the heart valves including the mitral valve. A stenotic mitral valve restricts the flow of blood from the left atrium to the left ventricle.
There are many patients with severe mitral regurgitation, and extensive open-heart surgery might not be possible for all kinds of patients. For such patients, transcatheter mitral valve replacement (TMVR) is an alternative treatment. TMVR can be applied to annuloplasty rings, degenerated prosthetic valves, or other kinds of native mitral valve ailments.
A patient undergoing TMVR will have to get admitted to the hospital or nursing facility the day before the surgery. This gives the healthcare team time to prepare the patient for the surgery in a proper manner.
Here is a brief description of what happens during the process of transcatheter mitral valve replacement (TMVR):
The patient is generally released after one or two days of the procedure. After they go back home, they have to follow some rules and regulations and also take the medicines properly as instructed. Follow-ups also need to be done at regular intervals to understand the progress taking place.
A balloon valvotomy is the preferred treatment for mitral valve stenosis. It is a procedure that widens the mitral valve so that blood flows more easily through the heart.
A balloon valvotomy is a minimally invasive procedure. A doctor uses a thin flexible tube (catheter) that is inserted through an artery in the groin or arm and threaded into the heart. When the tube reaches the narrowed mitral valve, a balloon device located on the tip of the catheter is quickly inflated. The narrowed or fused mitral valve leaflets are separated and stretched open as the balloon presses against them. This process increases the size of the mitral valve opening and allows more blood to flow from the left atrium into the left ventricle.
Balloon valvotomy is catheter-based, not surgical, and has a lower risk of complications and death than an open-heart surgery such as a commissurotomy or valve replacement.
After 3 to 7 years, about 35 to 50 out of 100 people need another procedure or surgery.
About 80 to 95 out of 100 people who are treated with a balloon valvotomy have successful outcomes and almost immediate symptom relief.
Transcatheter tricuspid valve replacement (TTVR) has the potential to fulfill this unmet clinical need. There are two broad categories of TTVR-orthotopic, where the valve is deployed at the tricuspid valve annulus, and heterotopic, where valves are deployed in one or both vena cavae
Several devices have been developed with different mechanisms of action. They are classified as annuloplasty devices, replacement devices, caval valve implantation and coaptation devices.
After a prior congenital heart disease surgery, adult patients may find that their implanted pulmonary valve is not functioning well anymore. If you have severe pulmonary stenosis or pulmonary regurgitation (leaky valve), your doctors may recommend a type of minimally invasive pulmonary valve repair and replacement surgery called Transcatheter Pulmonary Valve Replacement, or TPVR.
During this procedure, also called a valve-in-valve procedure, the new valve is placed inside your existing prosthetic pulmonary valve. Your cardiologist inserts a catheter (a thin, flexible tube) through an artery in your groin. Using expert imaging, your doctor then guides an expandable tissue valve to your heart.
A team of interventional cardiologists, imaging specialists and cardiothoracic anesthesiologists work together during a TPVR procedure. You’ll be under general anesthesia or conscious sedation for two to three hours. During the TPVR procedure, your cardiologist:
After the procedure, expect to spend up to three days in the hospital. Our cardiac team closely monitors your recovery and comfort. You can typically return to normal activities after about a week. Your doctor will instruct you about resuming or beginning medications after the procedure.
Compared to open-chest pulmonary valve replacement, nonsurgical pulmonary valve replacement has many benefits, including:
Following TPVR, your cardiologist may recommend outpatient cardiac rehabilitation. This program provides personalized support. Our expert therapists offer heart health education and guidance in exercise and proper nutrition.
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