Transcatheter Aortic Valve replacement is a valve replacement procedure done through “catheter means” without open surgery.
In the earlier version TAVR valves were very big (24 F) i.e 7.92 mm sized, with advances in technology, it is how smaller become (14 F to 16F)
Depending upon the patients artery size and the feasibility and size of device the arterial access site is chosen.
It has now been show that using transformal approach gives better acute and long term results turn for results with additional survival advances. Compared to surgery transfemoral approach is performed using the functional artery which is the largest artery in the grow using this artery, a completely precaution method using “proglide sutures” is a new inventions without using surgical cut downs. The important point is, it is done totally in a less invasive names with in making a cut down in arterial access.
When the catheters reach the heart and the valve, the cardiologist inflates a balloon in order to create an open space. After that he moves in the replacement valve all through the catheter to the appropriate place.
Most importantly, I must note that there are many types of valves. But I use two of the most progressive ones in the world – the self-expanding and the balloon expandable valve. The self-expanding valve is flattened using ice. This flattened valve will spontaneously expand and take its actual shape when warm fluid (water, or in this case, blood) flows through it. However, a balloon expanding valve must be “blown up” to provide shape to it, by the use of a small balloon.
These two valves are both valves compressed and collapsed to fit into the catheter. After the replacement valve is in place, the interventional cardiologist then goes forward to decompress it. He finally positions it in a precise manner, and then brings out the catheter. The new valve will then expand and push the old, malfunctioning valve to the sides. This will make the heart to get back to its complete, normal capacity right then. It is really rewarding that most of my patients improve quickly after the procedure.
Thus I can undoubtedly note that all these procedures are performed inside the heart, inside a space that is a fraction of a millimetre wide. Methods of this kind require major precision, experience, and a steady hand. It also needs the use of extremely sophisticated devices that permit the doctor to look into the heart without having to open it.
I believe the most satisfactory part in this is the ability to offer optimism for several of these patients who are left with no other option.Now-a-days we perform this procedure using conscious sedation- local anaesthesia as opposed to general anaesthesia which was used earlier.
Using local anaesthesia patient can be mobilized & discharged early even next day.
Thus the concept of less invasive TAVR which V standard 1st in india makes the procedure much more simplex with very start hospital stay and early discharge.