Transcatheter Aortic Valve Replacement at Narayana Health

What is Aortic Stenosis?

Aortic stenosis is a narrowing of the valve between the heart and the aorta. This is often caused by the build-up of calcium (mineral deposits) on the aortic valve’s leaflets. When the valve cannot fully open, less oxygen-rich blood flows to the body. This forces the heart to work harder to pump blood and eventually can lead to heart failure. The symptoms of aortic valve stenosis include chest pain, lightheadedness, dizziness, fatigue, and shortness of breath.

What is TAVR?

This minimally invasive surgical procedure repairs the valve without removing the old, damaged valve. Instead, it wedges a replacement valve into the aortic valve's place. The surgery may be called a Transcatheter Aortic Valve Implantation(TAVI) or Transcatheter Aortic Valve Replacement (TAVR). Somewhat similar to a stent placed in an artery, the TAVR approach delivers a fully collapsible replacement valve to the valve site through a catheter. Once the new valve is expanded, it pushes the old valve leaflets out of the way and the tissue in the replacement valve takes over the job of regulating blood flow.

What is involved in a TAVR procedure?

There are two different approaches to the TAVR procedure, and the cardiologist or surgeon chooses the one that provides the safest way to access the valve:

Transfemoral approach: Entering through the femoral artery (large artery in the groin), which does not require a surgical incision in the chest
Transapical approach: Using a minimally invasive surgical approach with a small incision in the chest and entering through a large artery in the chest or through the tip of the left ventricle (the apex)

How is TAVI or TAVR different from the standard valve replacement?

This fairly new procedure is FDA approved for people with symptomatic aortic stenosis who are considered an intermediate/high-risk patient for standard valve replacement surgery. In valve replacement, the chest is surgically separated (opened) for the procedure, but the TAVI or TAVR procedures can be done through very small openings that leave all the chest bones in place. People undergoing this procedure can experience an improved quality of life who otherwise face an intermediate risk with an open heart procedure.

Benefits of TAVR

Minimally invasive procedure
Less painful than the traditional open-heart surgery
The hospital stay is reduced to 4-5 days
Offers improved quality of life in patients who cannot undergo traditional aortic valve replacement

Some of the key facilities we offer:

Digital Cath Labs

Narayana houses 6 digital cath labs with state of the art, sophisticated equipment with the objective to provide only the best to those who lay their trust with us. Recent developments in cardiac surgery and interventional cardiology with new alternatives for aneurysm repair, valve replacements, shunt closure devices and aortic arch reconstruction have led to the creation of integrated, hybrid cath lab that allow both surgical and endovascular procedures.

These Hybrid Cath labs offer both surgical equipment and high-end angiographic equipment providing the best of both worlds.

Cardiopulmonary Exercise Test (CPET) Facility

Cardiopulmonary Exercise Testing (CPET) is a non-invasive method used to assess the performance of the heart and lungs at rest and during exercise. It requires the patient to perform mild exercises on an upright bicycle whilst breathing through a mouthpiece. Each breath is measured to assess how the body is performing and the capacity and strength of the lungs is measured before and during exercise. The heart tracing (ECG) is also recorded prior to, during and post exercise. Narayana offers in house CPET Facility to ensure complete convenience of the patients.

Electrophysiology Centre

Electrophysiology studies (EPS) are tests that help doctors understand the nature of abnormal heart rhythms (arrhythmias). The technique is used by doctors to assess the reason behind the abnormal beating of a person’s heart. In a normal scenario, electrical signals travel through the heart in a regular pattern. Heart attacks, aging and high blood pressure may cause scarring of the heart which may further cause the heart to beat in an irregular (uneven) pattern. During EPS, doctors insert a thin tube called a catheter into a blood vessel that leads to the heart. The electrical signals are studied through a specialized electrode catheter which lets the doctors send electrical signals to your heart and record its electrical activity. Narayana offers a state-of-the-art Electrophysiology Centre with specialized equipment for maximum convenience.

Heart Failure Clinic

Heart failure, sometimes known as congestive heart failure, occurs when the heart muscle doesn't pump blood as well as it should. Certain conditions, such as narrowed arteries in the heart (coronary artery disease) or high blood pressure, gradually leave the heart too weak or stiff to fill and pump efficiently. One can improve the quality of life by making lifestyle changes such as exercising, reducing sodium in your diet, managing stress and losing weight. Narayana houses a specialized heart failure center to ensure the highest quality of services are provided to the patients with utmost care.

Adult congenital heart disease clinic

Congenital heart disease (congenital heart defect) is one or more abnormalities in the heart structure that one is born with. It is one of the most common birth defects which can alter the way blood flows through one’s heart. Defects range from simple, which might cause no problems, to complex, which can cause life-threatening complications. Advances in diagnosis and treatment mean most babies who once died of congenital heart disease survive well into adulthood. However, signs and symptoms of the condition can occur in adults later in life, even those who had undergone treatment as a child.

Having a congenital heart disease may mean that one needs care throughout one’s life. Narayana has, at its heart a specialized Adult Congenital Heart Diseases Clinic ensuring the best in class service for its patients.

State-of-the-art critical care unit

A CCU or Critical Care Unit, is a special department of a hospital or health care facility that provides intensive treatment medicine and caters to patients with severe or life-threatening illnesses and injuries, which require constant care, close supervision from life support equipment and medication in order to ensure normal bodily functions. The CCU at Narayana is staffed with highly trained physicians, nurses and respiratory therapists who specialize in caring for critically ill patients. It is also distinguished from general hospital wards by a higher staff-to-patient ratio and access to advanced medical resources and equipment that is not routinely available elsewhere. Common conditions that are treated within CCUs include acute (or adult) respiratory distress syndrome, hypertension, metastases and other life-threatening conditions.

Valve Clinic

The aortic valve is one of four valves that regulate blood flow through the heart. These valves keep blood flowing in the correct direction through the heart. When the aortic valve isn't working properly, it can interfere with blood flow as well as force the heart to work harder to supply the necessary blood to the rest of your body. Aortic valve disease may not cause any signs or symptoms for many years, in some people while others may experience shortness of breath, fatigue, chest pain, loss of consciousness, irregular heartbeat (arrhythmia), heart failure and sudden cardiac death. With the specialised treatment provided at the Valve Clinic at Narayana, Aortic valve diseases are treated to help restore normal blood flow, reduce symptoms, prolong life and help preserve the function of one’s heart muscle. Also diseases of other heart valves ie mitral, pulmonary and tricuspid valve are investigated and treated in best possible way by dedicated heart valve diseases specialists.

Transcatheter Aortic Valve Replacement in India