Minimally invasive surgical procedure, TAVI, repairs a damagedaortic valve with a functioning one and is an alternative to open-heart surgery:
November 12, 2019, Dubai: American Hospital Dubai has performed its first Transcutaneous Aortic Valve Replacement (TAVI) procedure on a 91-year-old man. The TAVI procedure replaces the aortic valve in the cases of severe symptomatic aortic valve stenosis.
The American Hospital Dubai conducted the procedure on October 16 and the patient is now reported to be stable. Only 5 per cent of patients, worldwide, who have undergone the TAVI procedure, are more than 90 years of age.
The aortic valve is the primary and most crucial valve among the four heart valves. The narrowing of this valve can cause “severe aortic valve stenosis” and has a detrimental effect on the function of the heart which can lead to limitation of simple daily activities. Symptoms can range from extreme shortness of breath to multiple fainting episodes, from intense chest pains to sudden death. By replacing the aortic valve, a patient is able to enjoy a normal life once again.
Globally, around 30 to 60 per cent of patients with this condition are not offered open surgical aortic valve replacement heart surgery due to the high risk associated with it. But TAVI is a minimal invasive therapy that benefits such patients who would have been otherwise left untreated.
TAVI allows the interventional cardiologist with the assistance of heart surgeon to insert an artificial valve inside the diseased aortic valve through a 3 to 5 mm incision in the groin area. The procedure is done in the vast majority of times under local anaesthesia only and takes approximately 60 minutes. Patients can walk approximately eight hours after the procedure and remain in the hospital for an average of one to two days.
TAVI guarantees rapid recovery, as compared to open-heart surgery that has a long and debilitating post-operative recovery period which can last anywhere from 1-3 months. Under only local anaesthesia and with a very minimal invasive approach, the TAVI procedure incurs minimal risks with excellent results that are comparable to surgical aortic valve replacement (SAVR).
Dr. Firas Raouf Alani, consultant interventional and structural heart specialist, at the American Hospital Dubai says, “The patient had a long-standing history of heart disease. He had an open-heart surgery with coronary bypass 25 years ago, myocardial infarction and ischemic cardiomyopathy (EF 30-35%) and atrial fibrillation. In the past two months, he started noticing increasing shortness of breath that limited him in many ways from performing simple daily activities. He was referred to the American Hospital Dubai for evaluation.”
Subsequent screening of the patient revealed severe symptomatic aortic valve stenosis with evidence of active heart failure and atrial fibrillation. For the following subsequent two weeks, the American Hospital Dubai medical team improved some of his symptoms by modifying and optimizing his medical therapy regimen.
“This showed some improvement in his symptomatology, however, his continued limitation in performing routine daily activities, such as changing clothes or even walking for short distances, still proved to be a challenge. After consulting a team of heart surgeons, we decided to go ahead with aortic valve replacement. His case was not suitable for open surgical aortic valve replacement (SAVR) due to the extreme high risks related to his coexisting medical conditions. Therefore, we opted for TAVI,” said Dr. Alani.
The procedure was done successfully, and immediately after the procedure, the patient noticed a significant improvement in his symptoms and was discharged in stable condition after two days.