Category Archives: Cardiac Interventions

TAVI/TAVR (TRANSCSTHETER AORTIC VALVE IMPLANTATION/REPLACEMENT)

In a landmark advancement in the medical field in Odisha, The Kaling Institute of Medical Sciences (KIMS) has done the first case of Transcatheter Aortic Valve Replacement (TAVR). This state of the art procedure was done at KIMS by Cardiologist Dr. Anupam Jena and his team. The patient was discharged after 3 days.

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Transcatheter Aortic Valve Replacement (TAVR)  or transcatheter aortic valve implantation (TAVI) is a minimally invasive procedure that repairs the Aortic valve without removing the old, damaged valve. Instead, it wedges a replacement valve into the aortic valve’s place. Somewhat similar to a stent placed in an artery, the TAVR approach delivers a fully collapsible replacement valve to the valve site through a catheter. Once the new valve is expanded, it pushes the old valve leaflets out of the way and the tissue in the replacement valve takes over the job of regulating blood flow. This procedure is fairly new and is FDA approved for people with symptomatic aortic stenosis who are considered an intermediate or high risk patient for standard valve replacement surgery. Usually valve replacement requires an open heart procedure with a “sternotomy.”, in which the chest is surgically separated (open) for the procedure. The TAVR or TAVI procedures can be done through very small puncture in the femoral arteries at the groin leaving all the chest bones in place. A TAVR procedure provides beneficial treatment options to people who may not have been candidates for them a few years ago while also providing the added bonus of a faster recovery in most cases. A patient’s experience with a TAVR procedure may be comparable to a balloon treatment or even an angiogram in terms of downtime and recovery, and will likely require a shorter hospital stay (average 3-5 days).

Keywords: TAVI, TAVR, Cardiac Intervention, Aortic Stenosis, Transcatheter Valve Therapy

dilated aortic root

When to intervene in patients with bicuspid aortic valve and dilated aortic root or ascending aorta

Circulation – December 4, 2015

Surgery for Aortic Dilatation in Patients with Bicuspid Aortic Valves:

 A Statement of Clarification from the American College of Cardiology/ American Heart Association Task Force on Clinical Practice Guidelines

Intervention in Patients with BAV and Dilatation of the Aortic Root (Sinuses) or Ascending Aorta:

  1. Operative intervention to repair or replace the aortic root (sinuses) or replace the ascending aorta is indicated in asymptomatic patients with BAV if the diameter of the aortic root or ascending aorta is 5 cm or greater

 

  1. Operative intervention to repair or replace the aortic root (sinuses) or replace the ascending aorta is reasonable in asymptomatic patients with BAV if the diameter of the aortic root or ascending aorta is 0 cm or greater and an additional risk factor for dissection is present (eg, family history of aortic dissection or aortic growth rate ≥0.5 cm per year) or if the patient is at low surgical risk and the surgery is performed by an experienced aortic surgical team in a center with established expertise in these procedures

 

  1. Replacement of the ascending aorta is reasonable in patients with BAV undergoing AVR because of severe aortic stenosis or aortic regurgitation when the diameter of the ascending aorta is greater than 4.5 cm

CAROTID ARTERY STENTING: SILK ROAD PROCEDURE

SILK ROAD PROCEDURE

Innovation in carotid artery stenting.

Watch this nice animation to understand the concept

(downloaded from: http://www.silkroadmedical.com/silkroad-procedure/how-it-works/)

A recently presented trial (ROADSTER IDE) shows promising results for this new technique