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Advanced TAVI Technique

New Technology Offers Hope to Patients with Narrow Vessels 

Dr. Praveen Chandra, the Chairman of Interventional Cardiology at the Heart Institute in Medanta - Gurugram has performed India’s first Transcatheter Aortic Valve Implantation (TAVI) using the newly launched Evolut Pro+ TAVI technology - an advancement of the existing TAVI technologies to treat severe symptomatic aortic stenosis. The complex implantation was done recently for a 65-year-old patient suffering from severe aortic stenosis.

Calcific aortic stenosis - the most common valvular heart disease - is a major public health burden. TAVI is a novel procedure that brings hope to those suffering from severe aortic stenosis, which narrows the aortic valve acutely causing breathlessness and fatigue. The disease limits everyday activities of patients and worsens rapidly.

Unlike surgical aortic valve replacement, which requires a long incision down the chest (open-heart surgery), TAVI is a minimally invasive procedure done using a thin, flexible tube (catheter) passed through a few small incisions to reach the heart. The patient’s hospital stay, pain and chances of complications are minimized with this latest transcatheter technique to replace aortic valve. The new technology helps optimize procedural outcomes and future access.

Evolut Pro+ is a self-expanding valve made of nitinol frame and porcine pericardial tissues. Nitinol is an alloy that can be crimped in cold solution and once it comes up to normal temperature, through contact, it expands to its previous shape. A catheter with crimped valve is inserted into femoral artery, and guides the valve into the heart. Moving X-ray images in Cath Lab help the doctor place the catheter to the correct position. The catheter is removed once the new valve is securely deployed in place.

The next generation Transcatheter Aortic Valve System provides top notch safety and is a recapturable system, hence it can be retrieved and repositioned to achieve best results. This new system offers the lowest delivery profile for 23-29 mm valves, excellent hemodynamics allowing patients to return to activity sooner, the broadest annulus range, and advanced sealing with an external tissue wrap on all valve sizes.

With a reduced delivery profile for 23-29 mm valves, it is indicated to treat patients with vessels as small as 5.0 mm. With the ability to treat the broadest annulus range of any other available TAVI system, these new valves can treat annulus ranges from 18 mm to 30 mm.   

Dr. Praveen Chandra
Cardiac Care
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