Procedure explained
There is high tension during the Transcatheter Aortic Valve Implantation (TAVI) when the output of the heart stops for a brief moment and the pressure within the heart drops. Here, very steady hands and skill are of utmost importance, learns.
“Once we come into contact with the annulus (the base of the aortic valve that supports the valve's leaflets), there should be slow and then very fast or rapid deployment until we hear a kata-kata sound from the equipment which indicates that the deployment is done,” says Dr. Sepalika Mendis, pointing out that otherwise there can be obstruction of the coronaries which are supplying blood to the heart itself, damaging this vital organ.
Explaining TAVI which is less invasive and has a shorter recovery period than open heart surgery, Dr. Mendis says that what happens is that a new valve (made of natural porcine tissue) is guided with a catheter to the place where the diseased aortic valve is. (The natural tissue has been re-engineered and attached to a flexible expanding mesh frame.)
“We don’t do the insertion of the catheter blindly,” says Dr. Mendis, explaining that a dye is sent through the femoral artery first to get the pathway under the guidance of fluoroscopy (medical imaging).
The catheter with the valve was inserted into the femoral artery in Prema’s groin, after mak- ing an incision there. It was then guided through the descending aorta onto the ascending aorta and crossed over to be placed on the aortic valve opening and the new valve implanted over the diseased one. Thereafter, the catheter was removed and the valve started working. Before the new valve was delivered through the sheath, there was balloon dilation of the diseased valve to make way for the new.
Aortic stenosis is usually congenital (present from birth) or in later life due to calcification (accumulation of calcium salts on the aortic valve) or rheumatic heart disease.
The symptoms are shortness of breath, chest pain, angina (chest pain probably due to coronary artery disease) and syncope (fainting due to insufficient flow of blood to the brain).
