The transcatheter aortic valve implantation (TAVI) procedure significantly cuts down recovery time, giving patients the opportunity to continue their daily lives with minimal disruption.
“Four years ago, we were doing less than 50 cases a year but last year, we did over 150 cases,” said Dr Mahmoud Traina, physician at Cleveland Clinic Abu Dhabi.“So we are seeing a 25 percent year on year increase in demand for the procedure.”
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For 76-year-old Mohammed Iqbal Usman, who suffered from multiple complications including hypertension and artery diseases, TAVI was a lifechanger. Unable to undergo surgery due to the risks, Usman benefited from the procedure, which offered a less invasive alternative.
“His case required a nuanced approach due to the severity of his aortic stenosis and the risks associated with traditional surgery,” said Dr Naveed Ahmed head of cardiac services for Aster Hospitals and Clinics.“The TAVI procedure allowed us to precisely implant the valve through minimally invasive techniques, resulting in significant improvements in his quality of life."
How does TAVI work?
The aortic valve, located at the top of the heart, pumps blood through the body. With age, it can wear down, affecting heart function and health.
“When the valve becomes restricted, a condition known as stenosis, it causes the blood to flow through a smaller opening, which leads to a backup of fluid," Dr Mahmoud explained. "This results in symptoms like chest pain, shortness of breath, heart failure, and ultimately, death. Without valve replacement, life expectancy typically drops to two to three years after symptoms appear."
Dr Naveed added that until 15 years ago, the only option for such patients was to undergo an open heart surgery.“The procedure involved cutting open the chest, removing the old degenerated or damaged valve, and replacing it with a new one," he said.“Then the chest was closed and it used to take roughly around a month for them to get back to their normal lives.”
TAVI, on the other hand, involves inserting a catheter through the upper leg or chest and passing it towards the aortic valve to position a replacement valve over the existing one. Dr Mahmoud added that the valve replacement“takes about 45 minutes” to complete and“the patient is just mildly sedated” during the procedure.
Dr Mahmoud Traina
Benefits of TAVI
According to Dr Naveed, the procedure is especially suitable for older patients.“When we perform an open heart surgery, the surgery will be a success but post operation recovery is an issue, because with age, the healing process of the body slows down. TAVI patients, on the other hand, experience significant improvements in their quality of life,” he said.“They have reduced symptoms like shortness of breath, angina, and fatigue. They also have better physical activity and overall well-being.”
Dr Naveed Ahmed
Dr Mahmoud added that patients preferred it because of shorter recovery period of just a week as opposed to the six to eight weeks of recovery they needed in case open-heart surgery.“The patient is awake right after it and they go home the next day,” he said.“A week after they're back home, they're back to normal life. So the recovery is much quicker.”
However, he added that he wouldn't suggest the procedure to younger patients.“These valves tend to last somewhere between 10 to 12 years on average,” he said.“So if you have a 45 year old patient who goes for TAVI, then at 55 or 60, they're going to come back again. So we advise patients what's best for them in the long term.”