Introduction:

Transcatheter aortic valve implantation is a new procedure to allow replacement of a diseased (narrowed) aortic valve without open heart surgery. The aortic valve is the "outlet" valve of the left ventricle, controlling the flow of blood from the heart into the body.

What is Aortic Stenosis?

Aortic stenosis, the technical term for narrowing of the aortic valve, is seen increasingly commonly in older people, when it is assumed to be a manifestation of "wear and tear". When the aortic valve is normal, there is no resistance to blood flow through it, but in aortic stenosis the heart is placed under an increasing load as it pumps against the resistance that results from the narrowed valve. Severe aortic stenosis can cause breathlessness, angina, heart failure, black outs, and even death.

Once symptoms develop in severe aortic stenosis, between 50 and 80% of patients will die of problems related to the valve within 2 years, unless the valve is replaced. The standard of care in severe aortic stenosis is thus surgical replacement of the valve. Unfortunately, many patients, especially the very elderly, are not suitable for surgical valve replacement because of other conditions, such as reduced kidney function, chest problems and so on.

What TAVI can do for you

Transcatheter aortic valve implantation (TAVI) has made treatment possible for many patients who are not suitable for surgical valve replacement, or for whom surgery would carry a very high risk. In this procedure, which is generally performed with a general anaesthetic, a balloon is advanced to the heart from an artery in the groin, and used to push the diseased valve leaflets aside, opening the diseased valve to allow insertion of the new one. The new valve is then advanced across the diseased valve and implanted in position. (Patients who have severely diseased leg arteries can still be treated in some cases; for these people the new valve may be inserted through a small incision in the left side of the chest). Even for patients treated directly through the chest, there is no major incision made in the chest and the heart lung machine is not used.

What happens after the procedure?

After the procedure patients are intensively monitored, but are usually out of bed within 24 to 48 hours. Overall hospital stay is normally about a week.

What are the long-term outcomes?

The longest follow up with these valves is around 5 years, and so far no significant deterioration has been shown. The rate of complications in the initial series of over 40 patients treated at Mercy Angiography has been remarkably low.

Contact details for Mercy Angiography?

Address: 98 Mountain Rd, Epsom, Auckland.
Phone: 09 630 1961
Facsimile: 09 630 1962
Email: admin@mercyangiography.co.nz
Website: Mercy Angiography