By the time Mr. Post the successful completion of a Transcatheter Aortic Valve Implantation (TAVI) procedure, however, he recovered at an impressive pace. In just four days, he regained the strength to venture outdoors and cast his vote for the municipal elections.
He lived an independent lifestyle till he crossed the milestone of 93 years old and finally breathed his last due to a fall while playing with his grandchildren. Saravanan turned 87, he had a severely narrowed aortic valve that was impacting his daily activities to an extent where he required oxygen support for about a month.
Mr. Saravanan’s journey tells us the story of how far medical advancement in treating aortic valve disease has progressed. For those who qualify, TAVI offers a unique technique to replace the faulty aortic valve without undergoing the traditional open-heart surgery.
With increasing years, calcium deposits on these valves make them thickened and rigid. The term for this is ‘aortic stenosis’. Being born with only two cusps of the valve instead of three, makes such valves prone to wear out sooner. As symptoms intensify with time, the patient might encounter shortness of breath, discomfort in the chest area, dizziness or even fainting spells. These indicate worsening of the condition and must be addressed without further delay. A test known as an echocardiography is a painless diagnostic procedure using ultrasonic waves to assess the extent of narrowing of the valve, besides assessing cardiac function. For several decades, severe aortic valve diseases were treated only with open heart surgery. TAVI has revolutionised the entire process for eligible patients. In TAVI, a biological valve, usually bovine or porcine tissue stitched within a metallic frame, is placed at the tip of a catheter. The catheter is then typically inserted through the leg artery and moved all the way into the heart. At the site of the damaged valve, the new valve is deployed and it starts operating instantly. Its main benefit lies in quick mobilisation and most patients can be discharged within a few days after the procedure. There can be no denying the fact that TAVI is evolving rapidly as an interventional cardiovascular technique. Its origins lay in its development for patients who were deemed too risky for any kind of surgical intervention. It is important to understand that TAVI is not an option for everyone with aortic stenosis. It should be considered carefully in younger patients and in people with certain types of bicuspid aortic valve, an enlarged aorta or a need for additional bypass surgery. For patients diagnosed with aortic stenosis and found suitable for TAVI, the procedure can improve quality of life and help them live longer. By easing symptoms such as breathlessness, tiredness and chest discomfort, it may make everyday activities easier again. The decision should also be part of a lifelong heart valve plan that considers how long the replacement valve may last and what treatment options might be needed in the future.
This condition is most prevalent as age advances over 70 years, when the calcification of the valve becomes prominent due to wear and tear. In many cases, patients present with aortic stenosis at an earlier stage of life due to a birth defect in the aortic valve. Over time, it has become the procedure of choice in most patients with aortic stenosis over 65 years.
