Dr. Viveka Kumar, Principal Director & Chief Cath Labs Max Healthcare, is renowned for his expertise in new cardiac treatment needing surgical intervention such as TAVR and Innovative Minimally Invasive procedures. In a chat with The Week, he highlights the efficacy of these new and affordable techniques which have revolutionised intervention in Aortic Stenosis (AS), a valvular disorder. These procedures are becoming popular by the day among patients for enabling them to lead a normal life.
Which is the heart condition that Innovative Minimally Invasive procedure has proved to be the most effective treatment?
Innovative Minimally Invasive procedure is most suitable for treating the heart condition called Aortic Stenosis (AS) which is a severe aortic valvular disorder commonly found in elderly patients. The aortic value is found on the left side of the heart, which opens when the blood is pumped out of the heart to rest of the body. But when the opening of the aortic value is constricted reducing the flow of blood from the lower left ventricle to the main artery that carries blood to the entire body, the smooth functioning of the heart is disturbed. Aortic Stenosis is mostly prevalent in elderly people due to years of wear and tear scarring the tissues or calcium deposits in the flaps of the heart valve and also the vasculature. AS often occurs after the age of 60, but it mostly remains asymptomatic till the age of 70-80 years.
What are the different options available for treating AS?
Conventionally, the open-heart surgery is the most common treatment for AS, but it comes with the high risk of developing complications and at times is fatal too for elderly patients with co-morbidities. Approximately 40 percent of aged patients cannot risk being operated as they are very frail. For such patients, the minimal invasive alternative of Transcatheter Aortic Valve Replacement (TAVR), is the best choice available which significantly improve their quality of life and reduce mortality. During the procedure the new artificial valve is placed inside the diseased valve, which is not removed.
Could you explain in more detail about TAVR procedure?
TAVR is a minimally invasive surgery which can be conducted through small orifices with out having to open the chest as in open heart surgery for replacing the poorly functional aortic valve with a new artificial valve that is specially designed for implantation. A long and narrow tube or catheter, is inserted through the artery in the groin, which is known as the trans-femoral approach of TAVR procedure. The tissues on the flap of the artificial valve is developed from the natural tissues of the heart of a cow or a pig which is retreated and attached to a supple mesh frame.
What are the advantages of going for TAVR procedure?
TAVR is similar to a balloon angioplasty or angiogram when compared to the duration of the procedure and recovery needing fewer days of hospitalization unlike in an open-heart surgery. The risk of developing post-operative infection is also significantly reduced. Nevertheless, TAVR comes with complications which involves possibilities of haemorrhage, vascular complications, problems with the artificial valve, stroke, kidney disease, infection, irregular heart beat or arrhythmia and even heart attack etc.