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A new revolution in cardiac surgery: How does TAVI change the fate of high-risk patients?
With the advancement of medical technology, the way heart surgery is performed has also undergone revolutionary changes. Transcatheter aortic valve replacement (TAVI), as an emerging cardiac surgery technology, provides new hope for high-risk patients. This technology allows doctors to implant the valve through blood vessels, avoiding the high risks of traditional open-heart surgery, especially in elderly patients or patients with comorbidities. The development of TAVI marks a major shift in the field of cardiac surgery.
Basic Concepts of TAVI
TAVI is a type of heart surgery that does not require removal of the original heart valve. Its emergence has brought a ray of hope to many high-risk patients, especially those with severe aortic stenosis symptoms. The prognosis for these patients is generally poor, with a two-year mortality rate of up to 50% if untreated. Traditional open-heart surgery is too risky for some patients, and TAVI provides a viable alternative for these high-risk patients.
During TAVI, doctors can choose different interventional methods, including transfemoral, transapical, and transsubclavian, which not only reduces the patient's surgical risk but also shortens the recovery time.
Indications for TAVI
In the past, TAVI was mainly performed on patients who were not suitable for traditional surgery. But as technology improves and research increases, more and more moderate-risk patients are being considered for this surgery. Especially for patients under 75 years old, if TAVI is chosen, their long-term survival rate may not be guaranteed. Therefore, TAVI is often a more popular option for older patients.
Background of implanted devices
There are several TAVI devices on the market today, including Medtronic's CoreValve, Edwards' Sapien and St Jude Medical's Portico. These devices have excellent design and real clinical effects, and are therefore widely recognized by medical staff. According to evaluation results, these devices are effective in reducing mortality and improving physiological symptoms.
For example, Medtronic's CoreValve is made of a self-expanding Nitinol frame that allows it to be implanted smoothly in an artery.
TAVI operation process
The TAVI procedure usually does not require open-chest surgery; the doctor selects a suitable entry point and inserts the implant into the patient's heart. This procedure is done under anesthesia and requires comprehensive imaging to ensure the correct position of the valve. After the procedure, your doctor will make sure the valve is attached well and then remove the catheter.
Postoperative Care and Complications
After the TAVI procedure, patients will need regular medical checkups. This may include blood tests and imaging studies. Additionally, patients should be advised what symptoms to watch for after surgery, such as unusual fatigue or difficulty breathing. Although most patients recover relatively well after surgery, unexpected complications may occur, and it is important to observe leakage around the valve.
Approximately 3% of patients are at risk of experiencing a stroke following TAVI, a procedure that can present with a number of potential complications.
Future Outlook
As TAVI technology continues to develop, more and more studies will point out its long-term effects and the need for review. In the near future, we can expect to see more evidence-based guidelines to help healthcare providers develop treatment plans for high-risk patients. This also makes us think, how will new technologies in the future further improve the landscape of heart disease treatment?
