Alternative options: Aortic valve replacement surgery is done for rectification of damaged aortic valves. In this procedure, a different artificial valve replaces patient’s aortic valve. The aortic valve keeps the oxygenated blood flowing away from our heart for the requirement of our body. It acts as one-way swaying door that lets the blood flow in a forward direction and does not let the blood come back into the heart. This valve usually has three flaps and can be inflicted with disease due to a number of causes. The net result of these may make the valve either too narrow or it may let the blood slip back into the heart by becoming leaky. Open heart surgery is typically required to replace the valve if it becomes dysfunctional. Until recently, this procedure could only be done by open-heart surgery.
Percutaneous valve replacement
Aortic stenosis or the narrowing of the aortic valve is a common disease process in the adult population, with increased prevalence in advanced age. It is estimated that 300,000 patients have severe aortic stenosis in the United States, and approximately 60,000 patients undergo aortic valve replacement there every year. Up till now the only effective treatment for severe aortic stenosis had been aortic valve replacement, which requires an open heart surgery. In this operation, the breastbone or sternum is cut and the patient is placed on the heart-lung machine during the surgery. However, not all patients are suitable for this life-saving procedure and the most common reasons when this surgery is avoided in patients with severe disease had been advanced age and presence of other co-existing illnesses. The arrival of a percutaneous approach to Aortic valve replacement surgery where a synthetic valve is transported to the heart through a small hole made in the groin offers a new option to such patients who are, at high risk for surgery or those who cannot undergo surgery. This procedure is much similar to that of balloon angioplasty or putting up a stent in the heart arteries.
Transcatheter Aortic Valve Implantation (TAVI ) or Percutaneous Aortic Valve Replacement is the name that has been given to this new technique. In India, increasingly this technique is gaining momentum and more and more patients are undergoing this procedure.
Vision for the future
A. Cribier had been accredited with the first human implantation of a percutaneous aortic valve in April 2002 at the Charles Nicole University Hospital in Rouen, France. In a 57-year-old man with severe aortic stenosis, cardiogenic shock and multiple other illnesses, rendered unfit for surgery Cribier achieved this historic accomplishment. The procedure was a success with an excellent post procedure valve function. He had preceded his first endeavor by a number of trials in human cadavers in whom he had placed large stents for the experiment. Subsequent modifications of the original valve have led to improved paraphernalia and user-friendly kits. The results of the PARTNER trial or Placement of Aortic Transcatheter Valve trial, done at 25 U.S. and Canadian centers which have compiled about 1000 patients proved that Percutaneous method has resulted in remarkably improved survival. More recently, three additional trials reported non-inferiority of TAVI in intermediate-risk patients. Thus, this indeed had been one of the greatest and momentous breakthroughs of recent times. Needless to say, newer scientific innovations are increasingly making complex procedures easier, untreatable getting cured and deadly diseases being conquered.