Open Heart Surgery
Sometimes
when the patient is suffering from severe aortic stenosis and is evaluated as
“intermediate/serious risk” for surgery, he becomes eligible for a transcatheter
aortic valve replacement (TAVR) or conventional surgical aortic valve
replacement (SAVR). To choose a procedure is the first step. As the techniques
are presented as equally acceptable options, it is important to understand the
aspects of both the techniques to opt for one technique.
It is
important to understand the procedures with their corresponding factors
involved in Open Heart Surgery and Transcatheter Aortic Valve Replacement to
develop the perspective.
Pain - Openheart surgery is more painful than TAVR. TAVR doesn't require stitches, and
most of the patients have reviewed it by disclosing their experience: 'I had no
pain’ is what most patients have said. As the older and weaker people don't
have ability to bear pain, so TAVR is a miracle for them to get aortic stenosis
treated.
Hospital
Stay - The duration of hospital stay in open heart surgery is dependent on what
kind of surgery patient has. The length of stay after surgery vary from 3 days
to 5 days. If the scale of complications is high then stay may extend to several
weeks or longer. Whereas in TAVR the stay is for 3 to 5 days. Elderly and
weaker patients undergoing transcatheter aortic valve replacement (TAVR) are at
risk of hospital readmission postprocedure.
Risks -
Patients undergoing transcatheter aortic valve replacement (TAVR) are at risk
of increased mortality due to Aortic regurgitation, potential damage from
cerebral microemboli, increased need for pacemakers, and unknown durability of
the valve. Risks of open heart surgery include having a heart attack, heart
failure, or another cardiac issue depending on the number of arteries blocked.
Blockage in more arteries also means that the surgery may take longer or become
more complex.
Hospitals
and Surgeons for Open Heart Surgery in India and TAVR – Open heart Cardiac
surgery (remaining procedures) - Dr Ajay Kaul BLK, Dr Meharwal Fortis Escorts,
Dr Naresh Trehan Medanta, Dr Ganesh Mani Max smart hospital. Hospitals like
MAX, Gleneagles Global, Fortis, Rockland, Columbia Asia, and PSRI in India are
delivering high success rate with respect to SAVR and TAVR.
A Few Facts about TAVR
1. The first successful TAVR procedure was
performed in France on April 16, 2002, by Alain Cribier, M.D., University
Hospital Charles Nicolle in Rouen, France.
2. Until now more than 45,000 patients have
been implanted with Edwards’ transcatheter valves by multi-disciplinary heart
teams worldwide.
3. TAVR is an evolving procedure so risks and
uncertainty follows.
4. For inoperable patients TAVR is beacon of
hope.
5. The entire procedure of transcatheter
aortic valve replacement (TAVR) takes 1 to 2 hours.
It is very
important to understand both TAVR and SAVR with respect to all the factors
associated with them before undergoing any of the mentioned procedure. Patient
has no way of knowing whether their surgeon has a percentage or 50 percentage
mortality rate.