Transforming Cardiac Health: Exploring the Innovation of TAVI in Aortic Stenosis Management - Dr Anjan Siotia

Q. What is aortic stenosis, and why is it frequently seen in older patients?

A. Aortic stenosis (AS) is a condition where the aortic valve, which is one of the four valves of the heart, is degenerated and does not open properly. Since it is a degenerative condition and occurs most commonly due to ‘wear and tear’ of the valve, it is most commonly seen in old age people.

Q. What are the challenges associated with the traditional approach to treating aortic stenosis?

A. The main challenge with the traditional approach is that elderly patients tend to have many other comorbidities, thereby making open heart surgery and replacement of the valve a very high-risk procedure.

Q. Could you explain how transcatheter aortic valve implantation (TAVI) revolutionized the treatment of aortic stenosis, and what makes it an attractive alternative to open heart surgery?

A. TAVI involves replacement of the aortic valve under local anaesthesia, from the groin, through a small hole in the groin artery. This has revolutionized the treatment of Aortic Stenosis (AS) as there is no need for general anaesthesia and no need to cut open the chest for a high-risk open heart surgery.

Q. How has the acceptance of TAVI changed over time, and which patients find this procedure beneficial?

A. The acceptance for TAVI is universally great. Patients can walk the next day and go home in 2-3 days. There is no scar and recovery is very quick. Procedural risk is extremely low and long term results are as good or better than open heart surgery.

Q. How does TAVI work? What are its shortcomings, and is it unsuitable for some patients?

A. The TAVI valve is passed in a crimped state over a catheter inserted from the groin. Under X-ray guidance, the valve is positioned inside the native aortic valve and deployed by various mechanisms from the groin. The procedure in simple and quick. There are hardly any short comings. A very small proportion of patients are unsuitable due to adverse anatomical reasons.

Q. What is the difference between TAVI and stenting?

A.TAVI is a treatment for aortic valve while stenting is meant to clear blockages in heart arteries.

Q. What are the benefits of TAVI?

A. TAVI is minimally invasive. It does not require general anaesthesia. It has a quick recovery rate. It has low risk and yields very good long term results.

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