Rajan Thomas, a 70-year-old from Alappuzha, had been experiencing severe fatigue, shortness of breath, chest pain, and occasional dizziness. Initially attributing his symptoms to a past Covid-19 infection, a visit to his physician revealed a heart murmur, indicating a heart valve issue. Further tests confirmed that Rajan’s aortic valve, which regulates blood flow from the heart to the main artery, had narrowed and was not opening fully, causing his symptoms.
Rajan’s cardiologist recommended two treatment options: Surgical Aortic Valve Replacement (SAVR) and Transcatheter Aortic Valve Replacement (TAVR). SAVR, an open-heart surgery, poses higher risks, especially for older patients, whereas TAVR is a less invasive procedure. After consulting with his family, Rajan opted for TAVR.
TAVR has revolutionized heart valve replacement, especially for high-risk patients, by reducing complications such as stroke and bleeding, and significantly improving quality of life. Dr. G. Sengottuvelu from Apollo Group of Hospitals emphasized that TAVR has shown lower complication rates and substantial symptom improvement compared to traditional methods.
The TAVR procedure involves inserting a collapsible replacement valve via a catheter, typically through an artery in the groin or chest. The new valve, made from animal tissue, is positioned within the diseased aortic valve, which is then crushed against the aorta wall, allowing the new valve to function properly. The procedure takes about 3-4 hours and can be managed with general anesthesia for intermediate-risk patients like Rajan.
Dr. Harikrishnan S. from Sree Chitra Tirunal Institute for Medical Sciences and Technology noted that TAVR is particularly beneficial for patients who cannot undergo open-heart surgery due to high risks associated with conditions such as lung disease, renal failure, and advanced age.
Despite TAVR’s advantages, it comes with challenges. Not all patients are suitable candidates, necessitating additional tests to assess artery size and suitability for the procedure. Dr. Mathew Iype from Government Medical College, Thiruvananthapuram, mentioned the importance of performing tests like angiograms to ensure a good-sized artery for device insertion.
As reported by The New Indian Express, advancements in TAVR technology have made the procedure safer and more effective. Dr. Sengottuvelu highlighted improvements in valve designs, delivery systems, and imaging techniques since TAVR’s introduction in 2015. The availability of various types of TAVR valves, including the indigenously developed MyVal, has streamlined the process, reducing costs and improving accessibility.