For most health conditions, minimally invasive procedures are the most preferred. In recent years, the TAVI (Transcatheter Aortic Valve Implantation) or TAVR (Transcatheter Aortic Valve Replacement) procedure has become an established treatment option for people who don’t want the traditional surgical route or are in a high-risk category. This article will be your comprehensive guide on this procedure, who needs it, the benefits and the risks that accompany this treatment, costs and various factors for costs, recovery and recommendations.
What is TAVI/TAVR?
TAVI (transcatheter aortic valve replacement) or TAVR (transcatheter aortic valve implantation) surgery is a minimally invasive procedure, where a new valve is inserted into the body without removing the old and damaged valve. It’s an advanced treatment option that has increasingly become popular with the breakthrough it provides for cardiovascular medicine.
The TAVI procedure implants a catheter to a fully collapsible replacement valve through the blood vessel into the heart, via a small incision in the chest or groin. The old damaged valve is kept intact and not removed. During this procedure, a catheter-based pacemaker would be placed on the right side of your heart to control the patient’s heart rate. Once the new valve has been expanded, it pushes the old valve leaflets out of the way. After, the replacement valve’s tissues take over the task of regulating blood flow. Thus, there is no need for open-heart surgery using this option.
As described before, the TAVR (Transcatheter Aortic Valve Replacement) or TAVI procedure has two approaches:
- Transfermoral approach: To enter through the femoral artery in the groin, where there is no surgical incision required.
- Transapical approach: To create a small incision in the chest and enter through a large artery in the chest, or through the tip of the left ventricle.
Who Needs the TAVI/TAVR Procedure?
Valve replacements usually need open heart surgery. where the chest cavity is surgically opened for the procedure. However, the TAVI/TAVR procedure can be done through small openings that leave all the chest bones intact.
Therefore, the TAVI medical procedure has become the preferred treatment option for patients with symptomatic severe aortic stenosis that are at high risk for conventional open heart surgery. Apart from those patients, the procedure is one open to patients in all risk categories.
This procedure provides beneficial treatment options for people who may have not been considered for valve replacement. As it’s open to all people in all risk categories, it offers an effective solution to improve the quality of life for those who don’t have many choices for repairing their aortic valves. TAVI also offers a secondary option for people suffering from other symptoms as well. Patients from the age ranges of 65-80+ who either are able or unable to take blood thinners can undergo the TAVI procedure rather than conventional options.
TAVI/TAVR procedure complications
While this is a minimally invasive procedure, there are still some TAVR procedure risks.
1. Valve Leaks:
Sometimes blood can leak around the new valve because the replacement valve is not big enough, did not fully expand or has interference from buildup of calcium.
2. Pacemakers:
When valves open during the placement of the new valve, they can press on the electrical system of the heart. This calls for the necessity of a pacemaker during the procedure.
3. Kidney damage:
The contrast dye used through the vessels during the procedure for clarity and vision can hurt your kidneys, although this is a problem that can be rectified usually.
4. Vessel damage:
Vessels can be potentially damaged when catheters are passed through them, although the damage is usually repairable.
5. Stroke:
Although the percentage is small, there are cases of patients undergoing TAVR that have developed a stroke. This can happen during the procedure or in the following days after the procedure.
6. Death:
While this is an extremely low possibility, it is a concern that some people do not survive the procedure. The number of cases are very small, as the TAVR procedure success rate is very high!
We, the Heart Valve Experts, can help you determine whether TAVR could be right for you based on your unique medical history and personal health needs.
Benefits of TAVI: A Smarter, Safer Path to Recovery
As the TAVI procedure is minimally invasive when compared to surgery, there are various benefits to choosing TAVI:
It is less intrusive than open-heart surgery:
Since the procedure is minimally invasive, it avoids the chest being opened up and long hospital stays usually associated with open-heart surgery.
Shorter stay in the hospital:
Minimal cuts and fast recovery time means less time in the hospital, faster recovery in the comfort of one’s home, and an earlier return to daily life. For elderly patients or those with other medical conditions, this reduced physical strain is a blessing in medicine.
Reduced risk of complications:
Patients experience fewer issues like infections, probability of stroke, blood loss and stress which are common with traditional surgery. As the procedure only requires small cuts, there’s significantly less damage to the body – leading to lower chances of post-surgery problems and a smoother healing process.
Better outcome for older or high-risk patients:
The TAVI medical procedure is especially ideal for people who are older, have had previous heart surgeries (like bypass surgery) or other health concerns that make open-heart surgery too risky. These patients often cannot afford a long and difficult recovery period. With TAVI/TAVR, there’s less pain, fewer medications to handle, and a reduced need for rehabilitation after the procedure.
Improvement in other symptoms:
Patients who undergo TAVI also see a noticeable improvement in symptoms such as angina pain, breathlessness, fatigue or tiredness, dizziness and fainting, debilitated condition, heart failure and death.
Better health post-TAVI than post-open heart surgery:
One case study depicted how patients who underwent TAVI procedure had fewer strokes and occurrences of heart rhythm problems after 30 days, as compared to the health of patients post open heart surgery.
What Costs to Consider for The TAVR Procedure?
In India, the cost of Transcatheter Aortic Valve Replacement (TAVR/TAVI) varies widely on several variables, such as the location and hospital of procedure, types of valves, surgical expertise, pre-operational and post-operational care, personal hospital care, and insurance.
The national average of the TAVI procedure cost ranges from about 5 to 15 Lakh Rupees, however, the Mumbai region-specific charges can range from 8 to 28 Lakh rupees. For patients preferring treatments in top-tier hospitals, costs can range upto 36 Lakhs.
Here are some factors that would affect the overall TAVR procedure cost:
1. Location and Hospital Tier
Hospitals in metropolitan cities like Mumbai generally charge more due to the availability of advanced infrastructure and specialist care. Premium heart centres offer heart care support teams 24/7 on the clock, with quality ICU care which can raise final costs. Government or trust-fund run hospitals may be able to offer more affordable packages, with the drawback of limited customisation.
2. The Type of Valve Used for the Procedure
The choice of valve used for the TAVR medical procedure – whether balloon expanding, self-expanding, or locally made – impacts the overall cost greatly. Valves that are imported, such as Edwards or Medtronic, are more expensive than Indian valves such as Meril Myval. While valve selections are based on medical need, it’s important to consider affordable options that are still of quality.
3. Doctor and Surgical Team Expertise
Highly experienced interventional cardiologists in Mumbai with their surgical teams may charge more due to the specializations they bring. This increases overall cost, however provides a lower risk of complications with the greater expertise. Many patients choose senior doctors at high volume centres who have proven TAVR procedure success rates, even with higher fees. You can consult with top TAVR surgery doctors in Mumbai who lead specialized teams, such as Dr, Ankur Phatarpekar.
4. Pre and Post Operative Care
These costs include initial diagnostics (ECHO, CT scans), ICU monitoring, medications, physiotherapy and follow-ups. While the recovery protocols for TAVR are smoother and shorter than conventional surgery, intensive post-procedure care during the first 48 hours is critical for the patients. These supportive services in hospitals add up to the overall cost, bit by bit.
5. Insurance and Payment Options
It’s important to consider the kind of insurance you have as a patient as not all insurance plans fully cover the TAVR procedure. Some insurance plans may partially reimburse valve or hospital charges. Some insurance plans such as Mediclaim do cover TAVR, but the extent of coverage varies. Hence, it’s crucial to confirm pre-approvals and out of pocket expenses early before booking your treatment. Many hospitals now offer EMI or payment plans to help patients manage large costs more comfortably.
6. Room Category and Facilities
While this is a secondary concern with regards to the general cost of TAVR, choosing the category of stay for the medical centres during treatment can affect overall cost of the treatment. Private or deluxe rooms with advanced monitoring beds and personalised care services increase costs, in comparison to general or sharing rooms.
The Road to Recovery after TAVR/TAVI Procedure
Patients are usually closely monitored in the ICU following the surgery, but various factors determine how long you would stay in the hospital post-TAVR to recover. Some patients even return home within the next 24 hours after treatment. That’s one of the main advantages of the TAVR procedure recovery time. However, it’s important to be wary of the symptoms of infection: fever, increasing discomfort and redness, swelling or drainage at the catheter site.
For best recovery, several medications may be administered to patients:
- Anticoagulants – This medication aids in blood clot prevention, and your health status determines the length of time you may need to take this medication. It’s important to take these medicines exactly as prescribed!
- Antibiotics – These help treat and prevent bacterial infections as artificial heart valves can become infected. Most germs that cause heart valve infections originate in the mouth, but these infections can be avoided by taking appropriate oral care.
- Following TAVI, routine medical examinations and imaging tests are required to ensure the replacement valve is functioning as intended. It’s still important to inform your doctor of any new or worsening symptoms as mentioned above.
In today’s times, India has shown great promise advanced procedures like TAVR (Transcatheter Aortic Valve Replacement) and TAVI (Transcatheter Aortic Valve Implantation). Several world-class hospitals and highly skilled TAVI & TAVR specialists in India have made these procedures accessible to most of the population. These TAVI & TAVR specialists are experts in the field of interventional cardiology and use cutting-edge technology. Having successfully performed numerous complex TAVI & TAVR procedures, they deliver exceptional outcomes for patients in terms of quality of life and reduced symptom levels.
If you or your loved ones need to undergo a TAVI or a TAVR procedure, it is important that you choose the right interventional cardiologist. Consider factors such as years of experience, specialization, knowledge, success rates, post-surgery care, and patient testimonials. Dr. Ankur Phatarpekar is a leading TAVR specialist in Mumbai. He is a consultant interventional cardiologist with more than a decade of experience in interventional cardiology. Along with his team, he provides comprehensive care for people undergoing TAVR surgeries at the Heart Valve Experts. He is also a leading consultant at renowned institutions in Mumbai like Hinduja Healthcare, Breach Candy. Fortis Raheja, Wockhardt Heart Institute, Masina Hospital, Bhatia Hospital and Somaiya Superspeciality.
If you are considering undergoing TAVR or TAVi, consult with the top TAVR surgery doctors in Mumbai like Dr. Ankur Phatarpekar. He can reassure you of your worries, increase your confidence and provide the peace of mind needed for a successful procedure and enhanced recovery.
FAQs
The TAVI (Transcatheter aortic valve replacement) procedure offers quicker recovery, reduced length of hospital stays, and fewer complications compared to open-heart surgery. It also significantly improves heart function and quality of life while being minimally invasive.
It usually takes 1-2 hours with durations varying based on the complexity, The, and most patients are awake with light sedation during the process.
Recovery is generally faster than open-heart surgery. Patients can often resume normal activities within a week, with full recovery in a few weeks.
Yes, TAVI/TAVR is considered safe and is backed by extensive clinical studies. However, like any medical procedure, it involves risks such as bleeding, infection, or stroke.
Most patients require blood-thinning medication temporarily to prevent the formation of clots. It’s best to speak to your doctor about guidance tailored to your condition.
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