Better Health 34 ENG

+ Surgical aortic valve replacement
is the standard treatment, which
entails open-heart surgery to remove
the old valve and surgically implant
a new one.
+ But in Transcatheter Aortic Valve
Implantation (TAVI), the physician
inserts a prosthetic heart valve
through the femoral artery in the
groin or through a small cut on the
left side of the chest to get to the apex
(tip) of the heart. When the catheter
gets in the correct position at the
aortic valve, the surgeon releases the
new folded-up valve in the delivery
system to roll out and replace the
degenerated valve.
Surgery is not the solution for all
Although surgery is a highly effective
standard treatment for aortic valvular
stenosis, not all patients are able to
receive it. This major surgery requires
general anesthesia, use of a heart-lung
machine, and may take up to three to four
hours. Some patients may not be able
to withstand such an intense surgery,
especially the elderly, or those who have
previously had open chest operations,
and those with several underlying
diseases. The surgical mortality rate is
substantially high for these patients.
“If the medical team considers open
heart surgery too risky, we recommend
TAVI to reduce complications. This
6
method takes about an hour, and the
patient receives a small cut from
the incision, enabling quick hospital
recovery of only five to seven days. The
standard surgical method may require
two to three months of recovery,”
says Dr. Wattanaphol.
Suitable candidates for TAVI
+ Patients with severe aortic stenosis
+ Elderly patients, especially those
over 80 years of age
+ Patients with underlying conditions
such as lung disease, aortic atherosclerosis,
or who have previously
received cardiac surgery
Preparing the patient for TAVI
TAVI requires preparation, expertise,
and collaboration among medical
professionals such as cardiologists,
cardiac surgeons, anesthesiologists,
ultrasound physicians, skilled nurses,
and physical therapists. The TAVI team
at Bumrungrad has been internationally
trained and can explain the treatment
options and procedures to patients
and their relatives.
Above all, Bumrungrad International
Hospital values the quality and
standards of patient care. Our medical
team provides patients with thorough
and rigorous care, including diagnosis,
meeting with families before and after
the treatment, and close follow-ups, to
ensure that our patients receive the
best care in regaining health.
+ Patients with high surgical risk,
as determined by the attending
physician who assesses appropriateness
using standard riskfactor
analysis
+ Patients estimated to live longer
than one year, and who do not have
advanced cancer