Transcatheter aortic valve replacement (TAVR) has proven as an effective treatment option for heart patients as surgical aortic valve replacement (SAVR) is not effective even in low-risk elderly candidates and is different from traditional surgical treatments like open heart surgery, stated Dr A Sreenivas Kumar, director, cardiology & clinical research, Apollo Hospitals.
Dr Kumar stated that TAVR is a procedure, which is done through the skin (percutaneous) to replace a narrowed aortic valve that fails to open properly (aortic valve stenosis).
“Transcatheter aortic valve replacement is generally recommended for someone who is not suitable for surgery or is a high-risk candidate or intermediate-risk candidate for open-chest surgery, which is decided by heart team. TAVR procedure may be equivalent to a coronary angiogram/angioplasty in terms of recovery. TAVR enables physicians to replace a diseased aortic valve by entering a catheter through the groin,” added Dr Kumar.
TAVR is performed through techniques that involve small incisions on the groin, which renders the procedure painless and faster recovery time, while open heart surgery is the Aortic replacement through this modality is done by cutting open the chest and the heart is stopped and the patient is connected to a heart-lung bypass machine, or bypass pump during surgery and act as heart and lung when heart is stopped.
There are a number of surgical options available for treating patients with valvular disease such as open-chest and Mini AVR surgery, stated Dr Kumar.
Dr Kumar added, “Patients who have cardiac issues that require surgical treatment, such as multiple coronary artery disease, mitral valve disease or ascending aortic aneurysm are best suited for surgical aortic valve replacement and combined surgical operation that treats all these situations while performing the same operation. alternatively, coronary artery disease may be treated with coronary stents before performing TAVR and some mitral valve issues can be treated via a transcatheter approach.”
In open-chest surgery, the chest wall is surgically cut open and the blood circulation to the heart is maintained by a heart-lung machine used in bypass surgery, while in mini AVR surgery, the recovery period is shorter as the surgery is less damaging to the chest wall and surrounding areas.
“Immediately after both SAVR and TAVR there is a period of close observation either in an intensive care unit or another unit specialized in providing care. If you have been administered general anesthesia, then the period of waking up will typically last a few hours. For SAVR patients this period may be a day or two. Most patients would be advised to go home but few may be advised a recovery period in a specialized facility. Some TAVR patients can be discharged in one or two days,” added Dr Kumar.
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