Innovations in the Treatment of Aortic Stenosis: What’s Next for Interventional Cardiology?

Aortic stenosis, also known as aortic valve stenosis, is a type of heart valve disease that narrows and thickens the aortic valve due to calcium buildup or any other reason. This results in reducing or blocking blood flow to the aorta and the rest of the body. The most common technology used to treat aortic valve stenosis is replacing the diseased aortic valve with a prosthetic/artificial valve through open-heart surgery. But a few drawbacks regarding this treatment was the tendency for blood clot formation, surgical risks, and degradation of the artificial valve over the course of several years, requiring replacement. With each passing day, innovative treatment procedures are arising rapidly that are convenient for both doctors and patients, and have fewer adverse effects or chances for complications. Patients prefer non-invasive treatment options and are more compliant toward non-surgical therapies that offer speedy recovery. In this blog, we will discuss innovations in the treatment of aortic stenosis and how they impact patients’ lives for the better.

Innovative Treatment For Aortic Stenosis – Catheter-Based Options

Different catheter-based treatments are developing for treating aortic stenosis or other heart valve diseases. The major benefit of these procedures is that they are minimally-invasive and eliminates the need for fully opening the chest to treat the damaged valve. Now, more than 90,000 non-surgical catheter procedures are being performed worldwide to treat heart valve disease.
One research showed that patients with severe aortic stenosis and increased surgical risk had a higher 1-year survival rate with transcatheter aortic-valve bioprosthesis than people who had been treated with surgical aortic valve replacement.

Transcatheter Aortic Valve Implantation

Transcatheter aortic valve replacement (TAVR) is also known as transcatheter aortic valve implantation (TAVI). It is an ideal procedure for people at high risk for surgery complications.
Transcatheter aortic valve replacement is a minimally-invasive procedure followed by a minor incision in the chest or femoral artery (large artery in the groin). The catheter (thin, flexible tube) is placed in the femoral artery or chest after the incision, which travels to the aortic valve. After the catheter reaches the aortic valve, the doctor inserts a new valve inside the damaged one without replacing the diseased valve.

Benefits Of Transcatheter Aortic Valve Replacement

  • It has less chance of adverse effects than any other traditional open heart surgery.
  • It involves a shorter hospital stay and speedy recovery.
  • The procedure is less likely to cause death or major complications.
  • It has been shown to have lower rates of stroke and rehospitalization within a year after the process.
  • It has higher one-year survival rates, particularly in low-risk individuals.

Indications Of Transcatheter Aortic Valve Replacement

Transcatheter aortic valve replacement may be recommended in the following cases:

  • A diseased or damaged aortic valve that doesn't function properly.
  • Severe and symptomatic aortic stenosis
  • If the patient is suffering from any other chronic health issues, like kidney or lung disease, making surgery a risky option.

What Is the Success Rate of Transcatheter Aortic Valve Replacement

On average, the rate of procedural success of TAVR was estimated to be 94.8%, and only 11.2% of patients needed a second valve replacement.

Computed Tomographic (CT) Angiography With Transcatheter
Aortic Valve Replacement

Treating severe and symptomatic aortic valve stenosis with transcatheter aortic valve replacement is rising; however, the procedure requires precise patient selection and eligibility, easy strategies to access the heart valve, and prosthesis (artificial aortic implant) sizing for a successful treatment.
To comprehensively assess these factors, CT angiography is a highly effective imaging technique that allows three-dimensional assessment of the aortic root, prediction of prosthesis deployment, and evaluation of the femoral access root.
CT angiography is being used for peri-interventional evaluation and post-procedural imaging, which allows to identify and document of various risks and results associated with the transcatheter valve replacement beforehand, including:

    • Evaluation of the positioning of prosthesis.
    • Identification of procedural complications that show no symptoms.
    • Documentation of procedural success.
    • Computed angiography has also been shown to reduce vascular access complications.

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