In parallel with the development of technology, the application of the cover and placement system is getting easier every year. Today, it has been applied to more than 10,000 patients all over the world.
What is Aortic Valve Placement via Catheter?
In advanced age patients with aortic stenosis due to wear, who are in the risk group due to other accompanying diseases. TAVI (Aortic Valve Placement by Catheter Method), which was developed as a new treatment method for patients with high risk of open heart surgery and open heart surgery, started to be used all over the world after 2005. similar to bioprosthetic valves placed.
How is aortic valve placement performed with TAVI catheter method?
TAVI application in the catheter laboratory; Interventional cardiology, cardiovascular surgery, echocardiography and anesthesiology teams work together. Working together of the teams is the most important principle. The heart is reached through the aorta (carotid artery), and after the calcified aortic valve is expanded with a balloon, the biological tissue prosthetic valve is placed. It is monitored by echocardiography from the esophagus throughout the entire procedure. In this way, it is possible to measure precisely.
What is transapical application in aortic valve?
Aortic Valve Placement by Catheter Method (TAVI) due to arteriosclerosis and calcification in inguinal veins and aorta ) application is not possible, a small incision is made under the breast and the bioprosthetic tissue valve is placed from the apex (top) region of the heart. Placement of a bioprosthetic tissue valve from the apex (top) region of the heart.
What are the successes and risks of aortic valve placement with the TAVI Catheter method?
TAVI procedure; It is applied in advanced age, when the risk of surgical valve replacement is high. It is known that there is a life risk of more than 50% in 1 year if these patients are left alone. This risk with surgical valve replacement Although adequate reduction was not achieved in terms of cancer, PARTNER US and PARTNER EU studies showed that this risk for Edwards valve was reduced to around 30% with TAVI. In the patient group, there are risks that can be experienced after TAVI as in surgery and other interventions.
Complications reported in important scientific studies include; stroke 4.5%, serious problems related to the vascular access site 17%, severe bleeding 22%.
The rate of complications such as acute kidney damage, infarction, cardiac re-intervention, rhythm irregularity is around 1-2%.
>The probability of permanent battery insertion after the procedure is different between the valves and is reported between 4% and 40% in different series. How is the aortic valve placement (TAVI) procedure decided by the method?
The starting point in the preparation of the patient for this procedure is clinical evaluation. Complaints, examination findings and laboratory tests are evaluated whether they are suitable for TAVI procedure. The risk group of the patient is determined with the EuroScore and STS (Society of Thoracic Surgeons) scores, which are international risk determination scores. If a risk of over 20 for the EuroScore and over 10% for the STS score is detected, the benefit-risk indicator is evaluated that the TAVI procedure will be more beneficial.
Aortic valve placement (TAVI) with the catheter method preparations
Echocardiography prior to TAVI is considered the gold standard in the examination of the aortic valve. The diameter of the valve, the severity of calcification, the measurements made at the beginning of the aorta and the evaluation of the contraction strength of the heart are the most important steps. This procedure is performed by placing the receiver (probe) of the heart valves and cavities into the esophagus with a method similar to gastroscopy. In this way, the evaluation is made from the point closest to the heart. TAVI process Continuous monitoring of the valve with transesophageal echocardiography is preferred during the operation. At the same time, measurements should be made for the aortic valve by performing catheterization. If there is stenosis in the coronary arteries, it should be treated beforehand. If there is a possibility of stenting, it is recommended to apply a stent a while before the TAVI procedure, and then to place the valve in the second session.
CT Angiography for the aorta and leg vessels is recommended before the TAVI procedure. The measurement of vessel diameters is of great benefit in terms of the diameter of the aorta and leg vessels, the rate of calcification, examination of the angiography performed mostly with computed tomography, and the permeability of the valve and insertion system.
Read: 0
