Until recently, open-heart surgery was the standard therapy for aortic stenosis or narrowed aortic valve. Now, the condition can be treated with a minimally invasive procedure called Transcatheter Aortic Valve Implantation (TAVI). Fresh from the first non-surgical, balloon-mounted, heart valve replacement procedure in western India, Dr Jamshed Dalal, director, cardiac sciences, and Dr Sunil Wani, consultant, cardiology, at Mumbai’s Kokilaben Dhirubhai Ambani Hospital, discuss what causes aortic stenosis and the advantages of TAVI, which has the potential to replace open-heart aortic-valve replacement surgery in the future
Aortic stenosis or narrowed aortic valve is a common public health problem affecting millions of people around the world—it is estimated that up to 12.4 per cent of people over the age of 75 have aortic stenosis. About 80 per cent of adults with symptomatic aortic stenosis are males. Without treatment, half the people who fall ill from this problem die within two years.
What causes aortic stenosis?
If you notice these symptoms, you should first see your family doctor or cardiologist who may then refer you to a multidisciplinary heart team at a local hospital. Before your appointment, check with your family members to find out if any close relatives have been diagnosed with cardiac disease. Knowing as much as possible about your family’s health history will help your doctor make informed decisions. The above symptoms could also be those of heart congestion. So if you have been diagnosed with heart congestion, ask your doctor to test for aortic stenosis too. (The diagnosis can easily be made using 2D echocardiography.)
Treatment depends on how far your disease has progressed. If your stenosis is mild, medication may be prescribed. However, if you have severe stenosis, your doctor may recommend replacing your diseased aortic valve as severe aortic stenosis cannot be treated with medication.
Today, there are two options to replace your diseased aortic valve. A properly trained multidisciplinary team must conduct a thorough evaluation to determine the appropriate treatment option for you based on your overall health.
Salient features of TAVI
Aortic stenosis is a build-up of calcium deposits on the valve that causes it to narrow and reduces the blood flow to the rest of your body. Over time, the leaflets of the aortic valve become stiff, reducing their ability to fully open. When the leaflets don’t open fully, the heart must work harder to push blood through this narrow aortic valve and into your body. (Your heart cannot supply enough blood to your body.) Eventually, your heart gets weaker and this results in congestion of multiple organs, known as congestive heart failure, which could lead to death.
For more information contact Dr Sunil Wani at firstname.lastname@example.org
Photo: iStock Featured in Harmony — Celebrate Age Magazine January 2017
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