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Apollo Hospitals, Chennai successfully performed a complex Trans catheter Aortic Valve Replacement (TAVR) on a 70-year-old Patient

29 Apr 2017

Aortic Stenosis (AS) is a very common valvular heart disease and it can lead to significant mortality and morbidity in the elderly population. 14.5 lakh patients suffer with severe Aortic Stenosis in India and the prevalence of AS increases from 2% in adults over 65 years of age to 4% in adults over 85 years of age.

Apollo Hospitals performed a complex Trans catheter Aortic Valve Replacement (TAVR) surgery in a 70-year-old patient who had 2 aortic valve cusps with high calcification that made the case more complex. "A Normal Aortic Valve has 3 cusps. But in India we are seeing more patients with 2 cusps which result in early narrowing, thus making the case more complicated. Incidence of Bicuspid valves is 30-40% of the patients going for TAVR in India compared to about 15% in western data. It takes extensive expertise and care in successfully completing the surgery in such cases and we are excited to have achieved in saving the patient," said Dr. G Sengottuvelu, Senior Interventional Cardiologist, Apollo Hospitals.

TAVR procedure is minimally invasive catheter based procedure sometimes requiring general anaesthesia. Further to that, now we have further made this less invasive TAVR - performing the TAVR under local anaesthesia and percutaneous access without surgical cut down off the groin minimising hospital stay. "A very important feature of this TAVR procedure is that it has shown not only to improve the length of people's lives but also the quality of life. TAVR is a great addition to our ability to care for patients with valvular heart disease, and for the appropriate patient, we've seen outstanding results," said Dr. Sengottuvelu talking about the highlights of TAVR surgeries.

70 years old N Ramanathan, Retired Maths professor who was suffering from severe Aortic valve narrowing and severe lung disease had no treatment options as open surgery and also TAVR was considered high risk. However, we evaluated his condition and after much team discussion we decided to perform less invasive TAVR, which was done successfully. This is one of the valves with 2 cusps and calcium which fell in the highest risk category even for TAVR.

Patients with severe Aortic Stenosis often develop symptoms that can restrict their day to day activities, such as walking short distances and climbing stairs. These patients can often benefit by replacing their ailing valve. However, only two-thirds of the patients undergo the procedure every year across the globe. The main reason is due to lack of awareness. Once symptoms appear, untreated patients have a poor prognosis. Without treatment, symptomatic Aortic Stenosis will eventually lead to death. Thus, awareness on TAVR and its procedures need to be created among the patients as well as the experts.

The one day seminar highlighted the treatment procedurals, complexities and post procedure management of TAVR Surgery. Panel discussions on the "Life after TAVR" that gave a lot of insights and solutions for high risk patients with Aortic stenosis was also a major highlight of the event.

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