It Could Save Your Life
An interventional cardiologist specialising in coronary angioplasty and transcatheter interventions for valvular and structural heart disease, Dr Sanjeevan Pasupati is one of New Zealand’s leading cardiologists in structural heart disease.
He’s also the interventional cardiologist who performed the lifetransforming transcatheter aortic valve implementation (TAVI) procedure on Te Awamutu researcher and independent consultant Sharon Toi at Midland cardiovascular service (Braemar Hospital) (see separate story).
Director of the structural heart disease and cardiovascular research unit at the hospital, Dr Pasupati has a strong warning for people over 65 who suffer from problems such as shortness of breath, chest pains, loss of consciousness - or significant dizziness when walking. He says these issues are not caused by the side effects of normal ageing but could possibly be signs of a heart valve disease, such as aortic stenosis.
The very good news is, this is easily treatable thanks to procedures like the TAVI procedure - and TAVI is now available for a greater range of patient ages and existing medical conditions.The problem is, many people – and even their doctors, do not request treatment, for various reasons including the perceived risks. But ignoring the symptoms is in fact is much riskier. “Half of the people who develop severe symptomatic aortic stenosis die within about a year to a year-and-a-half, and pretty much all of them die within three years,” Dr Pasupati says. “It’s amazing the amount of publicity you get when you say, “Hey, I’ve got cancer,” but it’s not the same when you say, “I’ve got aortic stenosis”. Both diseases can have the same outcome, but aortic stenosis is very treatable and curable.” “The TAVI procedure significantly reduces morbidity and complications and is more comfortable for the patient.” “Most important, it truly saves lives in patients that are experiencing symptoms. And when your aortic stenosis is treated, you go back to your age match populations life span. What this means is, if you are 70 years old and have symptoms of aortic stenosis, without treatment this could mean another one to three years average life expectancy. Once treated this immediately returns to the age match population life span of another 15 to 20 years, on average”. Dr Pasupati adds.
He says the heart is like a pump: “Blood comes in and goes out controlled by valves, so the blood can go in one direction. There are four valves in the heart, and the aortic valve is the one that is the ‘gatekeeper’ of any blood that leaves the heart.” “All the blood that comes in must leave through the aortic valve back into the body. Aortic stenosis occurs when that valve becomes narrow mostly due to wear and tear over time. We don’t really replace the valve - we implant the valve inside the pre-existing valve.”
Since 2005, Dr Pasupati has performed several thousand of the TAVI procedures in New Zealand and many other countries. “I teach in countries all the way right from Japan right up to India. I have done over 1000 procedures in the Waikato alone.” “TAVI procedures are minimally invasive unlike open heart surgery, where the chest needs to be cracked open and the heart put on bypass”, he says. There is also much less risk of post-operative complications, with early recovery back to normal living within one or two weeks.
“If you feel that you have aortic stenosis and you want to explore the available treatment options (TAVI vs Surgery), please do as Sharon did: ask to see a cardiologist who performs TAVI and a cardiac surgeon who performs aortic valve surgery so you can make an informed decision.”
“This is your life. Be proactive, as you only get to live once.”