TAVR (Transcatheter Aortic Valve Replacement) valve-in-valve procedure recently performed at Fortis Malar Hospital, Adyar, Chennai by Dr E BABU, Consultant heart Failure & Interventional Cardiologist
65 years gentleman, who had undergone open heart surgery and aortic valve replacement with bioprosthetic valve for calcific aortic valve stenosis 14 years back, now presented with severe restenosis and dysfunction of this prosthetic valve. After evaluation, it was found that he had an intermediate risk for open-heart surgery, hence he was advised TAVR (Transcatheter Aortic Valve Replacement) procedure and he underwent the same. TAVR is a percutaneous procedure just like undergoing angioplasty usually performed through puncture in the groin blood vessel. Catheter was passed across the aortic valve in the heart. New TAVR valve was balloon expanded and implanted within the previous stenotic bioposthetic valve without any complications. Hence TAVR valve-in-valve procedure was successfully performed and the patient was discharged within 48hours.
Surgical Aortic Valve Replacement is a major surgical procedure involves open heart surgery performed under general anaesthesia, requires intubation and mechanical ventilation, hospitalization for a week and removal of stitches. TAVR is a percutaneous “no scalpel, no stitch” minimally invasive procedure, can be performed under local anaesthesia, with 3 days of hospitalization. The patient can be mobilized the next day after the procedure. Currently, TAVR procedure is indicated in patients with calcific native aortic valve stenosis or dysfunctional bioprosthetic aortic valve who are either inoperable or who have intermediate or high risk for open heart surgery.