Review of transcatheter aortic valve replacement procedure in aortic valve stenosis
Journal Title: Journal of the Indian Medical Association - Year 2018, Vol 116, Issue 2
Abstract
Severe symptomatic aortic stenosis is one of the commonest valve diseases due to various etiologies in elderly. Surgical aortic valve replacement (SAVR) was the treatment of choice in such cases. Transcatheter aortic valve replacement (TAVR) is the new alternative for patients with symptomatic severe aortic stenosis for whom traditional open chest surgery has intermediate or high risk. TAVR is less invasive with very short hospital stay. With availability of technical expertise and newer generation valves both the short term and long term results have significantly improved. Paravalvular leak after TAVR is quite common with first generation valves. But in newer generation valves with longer skirts the incidence of aortic regurgitation has come down. Vascular sequelae are independent predictors of death, largely attributed to the wider sheaths (inner diameter, 24F. 26F) required by earliergeneration devices. As the sheath sizes decrease with the new generation devices (14 F-equivalent system) the rate of vascular sequelae and the incidence of bleeding continue to decrease. India is very promising with percutaneous valve replacement therapy for other indications and other valves evolving fast.
Authors and Affiliations
G Sengottuvelu, S Thanu
Keywords
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