Transcatheter Aortic Valve Implantation (TAVI) Is As Effective As Open-Heart Surgery Study Shows

The heart is responsible for circulating oxygenated blood to various organs in the body. Once the heart stops pumping, other organs starve for oxygen and eventually die. Therefore, the heart can be described as the support of the human body.

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Some diseases affect the heart, ranging from tetralogy of Fallot, common in children, to cardiomyopathies. As these diseases progress, they tend to reduce the patient’s quality of life. Some electrolyte imbalances also affect the heart, such as magnesium, calcium, and potassium imbalances. Severe hyperkalemia, for example, can cause arrhythmias, leading to a heart attack.

Some screening tests that can help identify heart conditions include echocardiography, electrocardiography, and chest X-ray. Findings such as a prolonged QRS complex, fading P wave, and amplified R wave on the electrocardiogram suggest hyperkalemia. This can help guide the management of the patient with such findings.

Treatment for cardiac disorders depends on the etiology and includes medications, lifestyle changes, ablation, pacemakers, stents, and surgery. One of the surgeries for heart disease is open heart surgery. It is one of the oldest surgeries performed on the heart. The first successful open-heart surgery was performed by Dr. Daniel Williams on a patient on July 9, 1983 in Chicago. Other surgeries performed on the heart include minimally invasive surgeries such as transcatheter aortic valve implantation.

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TAVI surgery

Over the years, open heart surgeries were performed for most heart corrections such as heart transplants and heart valve repair until 2005. On January 5, 2005, Dr. McGinn, Jr. performed the first invasive surgery in the United States. It was necessary to verify the effectiveness of these surgeries compared to open-heart surgeries. And, in response to this need, Professor Toff and his team conducted research in the UK.

913 patients with an average age of 81 were randomly selected to undergo open-heart surgery or transcatheter aortic valve implantation (TAVI) at centers that perform these procedures in the UK. TAVI is used in the treatment of severe and symptomatic aortic stenosis. Using a catheter inserted into the chest, upper arm, or groin, which is moved to the valve of the aorta, a new valve is held over the old one. It’s less invasive than open-heart surgery.

The results obtained in patients operated either by TAVI or open heart were compared over one year. There was less bleeding and faster recovery time for patients who had TAVI. They also had better quality of life, functional ability and improvement in symptoms after 6 weeks of treatment. However, these patients were at higher risk of needing a pacemaker and having vascular complications.

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Initially, TAVI was offered to people not eligible for open-heart surgery and to those with higher operative risks. However, this study included those who were equipped for either procedure and had lower operative risks. The results showed that TAVI had similar results to conventional surgery, therefore it is also as effective as conventional surgery. However, further observations of research participants over a longer period, say 5 years, are needed.

Clinical significance

Invasive open heart surgery is a surgery used in the correction of certain heart conditions and comes with increased hospital stay and longer recovery time.

But, this study, which showed the similarity in the effectiveness of TAVI, has shed some light in the field of medicine. Patients can now enjoy fewer hospital stays, faster symptom improvement and less bleeding. Thus, a better improvement in the quality of life.

Conclusion

Transcatheter aortic valve implantation (TAVI), a procedure performed to treat aortic valve stenosis, has been shown to be similarly effective to open-heart surgery, with added benefits of less hospital stay and better improvement in quality of life. Hence, increasing the range of options for patients with aortic stenosis.

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References

Effect of transcatheter aortic valve implantation versus surgical aortic valve replacement on all-cause mortality in patients with aortic stenosis