Aortic stenosis with a high mortality rate is a significant cardiovascular concern. Non-surgical aortic valve replacement emerges as a game-changer

Aortic stenosis stands as one of India’s most prevalent valvular heart diseases, trailing only hypertension and coronary artery disease. Its prevalence surges with age, affecting roughly one in ten individuals aged 75 or older. The condition, characterised by a narrowing of the aortic valve opening, often manifests with symptoms such as chest pain, fatigue and shortness of breath, impacting the quality of life for affected individuals.

The primary causes include degenerative valve disease, congenital bicuspid aortic valve disease and rheumatic heart disease, the latter being the leading global cause of aortic stenosis (AS), particularly among children and young adults.

Despite an initially asymptomatic phase that may last for several decades, the prognosis dramatically changes once symptoms develop. Without timely intervention, such as aortic valve replacement, the average survival rate dwindles to a mere 2-3 years, elevating the risk of sudden death.

The early symptoms of aortic stenosis are frequently overlooked or misattributed to other causes. Nevertheless, recognising the significance of symptoms and promptly seeking medical attention is critical in mitigating the progression of the disease. For individuals diagnosed with aortic stenosis, heart valve replacement surgery often becomes a necessary course of action. This surgical intervention aims to repair or replace faulty heart valves, restoring proper blood flow and alleviating symptoms. According to a report by GlobalData, approximately 69,592 heart valve surgeries are conducted each year in India.

The heart’s proper function relies on valves, ensuring blood flows in one direction. When valves malfunction, surgery becomes necessary to repair or replace them. This may involve fixing leaflets that don’t open wide enough or don’t close tightly, ensuring blood flows properly through the heart chambers and arteries. Replacement valves can be sourced from animals, human tissue, or synthetic materials.

TAVI & TAVR for AS

Transcatheter Aortic Valve Implantation/Replacement (TAVI/TAVR) is a ground-breaking alternative procedure to open heart surgeries. TAVI/TAVR is a minimally invasive procedure that involves inserting a new valve inside the damaged aortic valve, often without removing the old valve entirely. The procedure itself involves inserting a catheter through an artery in the groin, which is then guided to the heart.

The number of patients afflicted with blocked arteries and co-morbidities like hypertension, diabetes and chronic kidney disease is increasing day after day. The ideal solution for such patients is TAVI procedure, as it offers significant benefits over traditional treatments. However, only a small percentage end up opting for it. Addressing aortic stenosis early, especially in patients with multiple co-morbidities, is crucial for improving outcomes and enhancing quality of life.

TAVI Therapy Helps

Mrs. Patel, a 78-year-old woman, was struggling with severe degenerative aortic stenosis. Mrs. Patel’s condition, made it hard for blood to flow through her heart properly.

This caused her heart to work harder, leading to symptoms like chest pain and feeling breathless. Her doctor suggested a treatment called TAVI (Transcatheter Aortic Valve Implantation), a less invasive procedure where a new valve is placed inside the damaged one. The deployment of the valve was successful, with Mrs. Patel responding positively to the procedure. Remarkably, within just three days, Mrs. Patel was discharged from the hospital. Subsequent assessments revealed no signs of valve issues or blockages in her heart. Her journey underscores the remarkable impact of interventions like TAVI in restoring health and well-being.

(The writer is Senior Director and Head of Interventional Cardiology at Max Super Speciality Hospital, Delhi; views are personal)