AHMEDABAD, MARCH 10
A septuagenarian who was diagnosed with severe aortic stenosis underwent a minimally invasive surgery or transcatheter aortic valve replacement (TAVR) without anaesthesia at Apollo CVHF Heart Institute in Ahmedabad on Monday.
The surgery was performed on the 72-year-old patient by a team of cardiologists led by institute director Dr. Sameer Dani and one of the pioneers of TAVR in the world Dr. Raj Makkar, Director Cardiology Services, Cider Sinai Hospital, Los Angeles, California, USA.
Speaking to the media, Dr Dani said, “This transcatheter aortic valve replacement (TAVR) surgery was done under an agreement between Apollo CVHF Heart institute, Ahmedabad and the Ciders Sinai Hospital, Los Angeles, USA from where we will bring this procedure (TAVR) to Ahmedabad whenever required, which will benefit the patients from Gujarat.”
“TAVR may be a preferred option for people who have been diagnosed with severe aortic stenosis. TAVR is less invasive than open-heart surgery. About 12 per cent of our senior citizens in the age group of 65 and above are afflicted with this problem. Aortic valve stenosis is a health condition that becomes a hurdle in their lifestyle. Breathlessness, syncope and chest pain hampers their day to day activity. Aortic valve disease is a progressive narrowing of the exit valve from the heart (Left Ventricle). Symptoms often come gradually with a decreased ability to exercise occurring initially. The common risk factors are hypertension, diabetes, smoking, increasing age and being male. Many patients may have severe aortic stenosis but remain asymptomatic. There are multiple modalities to treat this disease. The mild and moderate disease is treated with medications. In case of severe aortic stenosis and the patient being not too old with low surgical risk, the preferred option is surgical aortic valve replacement. In age-old patients who are at high risk for open-heart surgery, TAVR has emerged as an excellent option. The outcomes of TAVR are excellent with shorter procedure time, an early recovery which helps patients to get back to everyday activities,” Dr Dani added.
When asked about the tissue valve, Dr Dani explained “The valve is made of animal tissues and costs between Rs 18 lakh and Rs 20 lakh. Over and above the surgery will cost Rs 4 lakh to Rs 8 lakh. Since TAVR is a new procedure we don’t know whether it is covered under medical insurance or not in our country but in US it is covered in insurance.”
Elaborating on the benefits of TAVR Dr. Raj Makkar, Director Cardiology Services, Cider Sinai Hospital, Los Angeles, California, USA, who has done maximum number of TAVR procedures globally to said, “One of my patients was a centenarian after TAVR he lived for over six years. Over one lakh had underwent TAVR in US out of which 700 surgeries were done at Cidar. Unlike surgery, TAVR is now often done without or with minimal anesthesia and with next-day discharge from the hospital.”
“During the TAVR procedure, an interventional cardiologist inserts a replacement valve into a catheter and guides it through an artery to the patient’s heart, where a balloon is expanded to press the valve into place,” DR Makkar added.
Aortic stenosis often results in death within three years of diagnosis. Replacing the aortic valve – either through the TAVR procedure or surgery – restores patients’ life expectancy to normal.
