http://www.drravindersinghrao.com/wp-content/uploads/2017/04/tavr.jpg

This pic shows the catheter valve procedure

TAVR


WHAT IS TAVI/TAVR?

Transcatheter Aortic Valve Replacement (TAVR) is the latest milestone in the field of interventional cardiology. It refers to transcatheter aortic valve implantation/replacement, which is a procedure where aortic valve is replaced with a biological valve without open-heart surgery. It increases survival of the patients.

AM I ELIGIBLE FOR TAVI?

TAVI is presently used in patients who are high risk or intermediate risk for open heart surgery. It is a biological valve and has shown similar results as open heart surgery in various trials. For further details please use this contact form.

WHAT IS THIS VALVE MADE OF?

There are many valve which are in the pipeline of development. Two valves that are widely used are Sapien valve and Corevalve. Sapien valve is a balloon expandable valve made of bovine pericardium and sewn inside a metallic stent. Corevalve is a self-expanding valve made of porcine pericardium sewn inside a nitinol frame.

HOW IS THIS VALVE INSERTED?

90% of the valves are inserted via femoral(groin) approach. This allows early ambulation and discharge. The other approaches are trans aortic, trans axillary, trans apical.

MITRACLIP

Mitraclip is a catheter-based procedure (Non-surgical) to treat leaky mitral valve otherwise called mitral regurgitation.
http://www.drravindersinghrao.com/wp-content/uploads/2017/04/mitralclip.jpeg

HOW DOES IT WORK?

It clips the leaky segment of the valve and approximates them when the valve closes, thereby treating the leak. For further details please use this contact form.

HOW SAFE IS THE PROCEDURE?

It is a safe procedure when done at a center of excellence and by an expert. The procedure is done from the femoral(groin) vein. The chances of bleeding are minimal.

HOW DOES IT EFFECT THE QUALITY OF LIFE?

Successful implantation of Mitraclip reduces the leak. It improves the symptoms dramatically and decreases recurrent hospitalization.

IS IT USEFUL IN HEART FAILURE?

Mitraclip is widely used in Europe for functional mitral regurgitation. It improves patient symptoms and heart function.

BALLOON MITRAL VALVULOPLASTY

Balloon mitral valvuloplasty refers to the process where in tight mitral valve is opened using a balloon, thereby relieving obstruction to filling of left ventricle. For further details please use this contact form.

BALLOON AORTIC VALVULOPLASTY

Balloon aortic valvuloplasty is treatment of aortic stenosis by a balloon catheter. It is a very good treatment option for congenital aortic stenosis and for patients who are not suitable candidates for aortic valve surgery. For further details please use this contact form.

BALLOON PULMONARY VALVULOPLASTY

Balloon pulmonary valvuloplasty is treatment of pulmonary stenosis(tight pulmonary valve) by balloon dilatation, thereby avoiding surgery. Most common cause of pulmonary stenosis is congenital heart disease.

VALVE IN VALVE PROCEDURE

Valve in valve procedure refers to transcatheter(non-surgical) valve replacement in a patient who has dysfunctional biological valve either in aortic valve position or in mitral valve position. For further details please use this contact form.

PARAVALVULAR LEAK CLOSURE

WHAT IS PARAVALVULAR LEAK?

Paravalvular leak referes to a leak following surgical aortic valve replacement. It is leak from the side of the new valve due to suture breakdown. For further details please use this contact form.

WHAT ARE SYMPTOMS OF PARAVALVULAR LEAK?

If a patients symtoms do not improve following open heart valve surgery, then one should suspect paravalvular leak. It can present as congestive heart failure or hemolytic anemia due to breakdown of blood cells. It is also a nidus for infection.

WHAT TEST IS REQUIRED FOR ITS DIAGNOSIS?

2-D Echo, Transesophageal echocardiogram(TEE) and CT scan helps in diagnosing paravalvular leaks.

IS REPEAT SURGERY A TREATMENT OPTION?

Yes repeat surgery is a treatment option, especially when the leak is very big. It happens when more than 40% of the circumference is dehisced. However, repeat surgery carries high morbidity, mortality and recurrence rate of approximately 30%.

WHAT IS NON-SURGICAL TREATMENT OF PARAVALVULAR LEAK CLOSURE?

Paravalvular leaks can be closed using plugs by catheter (without open heart surgery). It is a safe procedure and success rate is more than 90%. It is done in a cardiac catheterization lab. For further details please use this contact form.