The heart comprises four primary valves, and among them is the aortic valve, responsible for preventing the backflow of pumped blood from the left ventricle. When this valve is afflicted with a condition, it is referred to as aortic valve disease. While the aortic valve is typically tricuspid, some individuals may have a bicuspid valve from birth. It’s noteworthy that bicuspid aortic valves tend to develop diseases earlier than their tricuspid counterparts.

The aortic valve may experience either leakage, known as aortic regurgitation, or narrowing, termed aortic stenosis. Diseases related to the bicuspid valve tend to manifest earlier, and it can also be susceptible to disease resulting from childhood infections. On the other hand, aortic stenosis is typically associated with aging and is characterized by valve degeneration, often attributed to the deposition of calcium.

In the past, open-heart surgery was the conventional method for treating aortic valve disease. However, as aortic stenosis is predominantly a condition of old age, many individuals may not be suitable candidates for surgery. For patients deemed high risk for surgical intervention, transcatheter aortic valve implantation (TAVI) now stands as a highly viable alternative.

TAVI represents the latest approach for addressing aortic stenosis in patients. This procedure involves replacing the aortic valve without the need for chest opening; instead, it is performed through minimally invasive keyhole surgery conducted via the leg artery, akin to the methodology used in angioplasty.

In the past, surgically replaced valves were either metallic or tissue-based. If the prior valve is a tissue valve, TAVI is a feasible option.

TAVI valve is a biological tissue valve.

No, the patient is not put on heart lung machine.

95% of the time general anesthesia will not be given to the patient.

Following TAVI, the patient is promptly transferred to the Intensive Care Unit (ICU). On the subsequent day, a thorough assessment is conducted, and if the conditions are favorable, the patient is encouraged to walk and monitored. Upon confirming stability, the patient is then moved to a regular room. Observation continues for an additional day before the patient is deemed fit for discharge and can return home.

TAVI is performed to treat and enhance your condition. There will be no restrictions or delays in your activities. You will be able to resume all your regular activities immediately after discharge and experience a significant improvement in how you feel.

This valve is one of the four major valves in the heart, preventing the backward flow of blood from the left atrium to the left ventricle. The condition affecting this valve is referred to as mitral valve disease. When the valve exhibits leakage, it is termed mitral regurgitation, and if it undergoes narrowing, it is referred to as mitral stenosis.

In younger patients without calcium deposits on the valve and a clear left atrial appendage, balloon mitral valvotomy (BMV) can be performed. However, if there is calcium deposition on the valve and the left atrial appendage contains a clot, mitral valve replacement surgery is recommended. The replacement can involve either a metallic mechanical valve or a tissue bioprosthetic valve. Your doctor will guide you on the most suitable option for your specific needs.

Mitral regurgitation can occur as a result of infection, either in early or late stages of life. It can also be functional, arising from structural abnormalities in the valve apparatus. In cases of severe rheumatic mitral regurgitation, the preferred treatment is surgical open-heart mitral valve replacement. On the other hand, if the regurgitation is functional, the option of mitraclip can be considered.

Ideal candidates for mitraclip are patients with functional mitral regurgitation (MR) whose valves are deemed suitable based on Transesophageal Echocardiogram (TEE) and 3D Echocardiogram (ECHO). These individuals are experiencing heart failure despite receiving optimal medical therapy and have declined open-heart surgery due to additional co-morbidities.

MitraClip is performed under general anesthesia without the need to open the chest; instead, the procedure is conducted through the groin. While most patients typically need a single clip, there are cases where two clips may be necessary. Following the procedure, the patient is transferred to the Intensive Care Unit (ICU), where their recovery is closely monitored.

MitraClip is undertaken to alleviate the symptoms experienced by patients. Following discharge, the majority of individuals report a significant improvement in their well-being and find themselves capable of resuming their day-to-day activities with greater ease.

This procedure is performed at a center of excellence by a doctor who specializes in this field. Nevertheless, it is important to note that, like any other medical procedure, this intervention carries inherent risks.

This procedure is undertaken for patients experiencing symptoms of heart failure despite optimal medical therapy, specifically those with a dysfunctional tissue bioprosthetic mitral valve replacement. Conducted through the groin, the majority of patients are typically discharged within a day or two. Notably, this procedure involves lower risks compared to surgery and generally offers a faster recovery process.

Several risk factors contribute to the onset of cardiovascular disease. While some individuals may be born with conditions predisposing them to heart disease and stroke, the majority develop cardiovascular issues due to a combination of factors like an unhealthy diet, insufficient physical activity, and smoking. The greater the exposure to risk factors, the higher the likelihood of developing cardiovascular disease. Many of these risk factors contribute to atherosclerosis, the gradual narrowing and thickening of arteries. Atherosclerosis can progress for years without manifesting symptoms and can occur in various parts of the body. When it affects the heart, it is termed coronary artery disease, and in the legs, it is referred to as peripheral arterial disease. The deposition of fatty material, cholesterol, and other substances in the vessel walls leads to the formation of plaques, causing the narrowing and thickening of arteries. The rupture of a plaque poses the risk of a stroke or a heart attack.

There are various methods for diagnosing coronary heart disease. One common diagnostic tool is a coronary angiogram, which involves introducing a dye into your arteries and using an X-ray to visualize how blood flows through your heart. The resulting image, known as the angiogram, can reveal any signs of atherosclerosis. Another diagnostic test is an electrocardiogram (ECG or EKG). This non-invasive procedure records the electrical activity of your heart, providing information about the heart rate, regularity of heartbeats, size and position of heart chambers, presence of any heart damage, and the effects of drugs or devices used to regulate the heart.

Blood pressure is the force exerted by blood as it moves through your arteries, pushing against the arterial walls. High blood pressure, or hypertension, arises when the very small arteries (arterioles) constrict. This constriction causes the heart to exert more effort in pumping blood through the narrowed spaces, leading to an increase in pressure within the vessels. The sustained elevated pressure on the artery walls weakens them, rendering them more vulnerable to the development of atherosclerosis.

Smoking harms the endothelium of blood vessels, enhances the accumulation of fatty deposits in arteries, elevates the tendency for blood clot formation, negatively impacts blood lipid levels, and triggers coronary artery spasms. Additionally, nicotine from smoking accelerates heart rate and raises blood pressure.

The signs of a heart attack in men typically include intense chest pain, discomfort in the left arm or jaw, and difficulty breathing. In contrast, women may exhibit similar symptoms, but the pain can be more widespread, extending to the shoulders, neck, arms, abdomen, and even the back. A woman might perceive the pain more akin to indigestion, and it may not be constant. Some women may not experience pain but instead report unexplained anxiety, nausea, dizziness, palpitations, and cold sweats. Notably, a woman’s heart attack might be preceded by unexplained fatigue. Moreover, women tend to have more severe initial heart attacks that, unfortunately, more frequently result in fatalities compared to men.

Treatment options for coronary heart disease (CHD) encompass lifestyle modifications and, if necessary, medications and specific medical procedures. Adopting a healthy diet can aid in preventing or reducing high blood pressure and elevated blood cholesterol levels, facilitating the maintenance of a healthy weight. Incorporating physical activity, stress management, and quitting smoking are essential lifestyle changes. If lifestyle adjustments prove insufficient, medications may be prescribed to alleviate CHD symptoms, reduce the heart’s workload, lower cholesterol and blood pressure, prevent blood clots, and potentially delay the need for procedures or surgery. In cases where interventions are required, both angioplasty and coronary artery bypass grafting (CABG) are employed to address blocked coronary arteries. The choice between these treatments can be discussed with your doctor based on your specific situation.

Angioplasty is a non-surgical intervention designed to open narrowed or blocked coronary arteries. It involves the insertion of a thin, flexible tube equipped with a balloon or similar device through a blood vessel, directing it to the affected coronary artery. Once positioned, the balloon is inflated to compress the plaque against the artery wall, restoring normal blood flow. During the procedure, the doctor may also place a small mesh tube known as a stent in the artery. This stent serves to prevent future blockages in the months or years following angioplasty. Stents come in two categories: bare-metal stents and drug-eluting stents. The latter, being a newer generation, is coated with medication that is gradually released to impede the growth of scar tissue in the artery lining. This helps maintain the artery’s smoothness and openness, ensuring optimal blood flow.

In the process of diagnosis, your doctor will inquire about your symptoms, medical history, and risk factors. Subsequently, based on this information, your doctor may recommend tests to assess the health of your arteries. The most prevalent diagnostic tests include:

ECG (Electrocardiogram)
ECHO (Echocardiogram)
Stress Test
Angiogram
CT Scan
Magnetic Resonance
Angiography (MRA)

Frequently misconstrued as a heart attack, sudden cardiac arrest (SCA) is distinct but can occur in individuals who have survived a heart attack. A heart attack arises from a circulatory or plumbing issue within the heart, resulting from blockages in one or more arteries, impeding the heart’s access to oxygen-rich blood. If the heart muscle does not receive sufficient oxygen, it becomes damaged. Risk factors for a heart attack encompass high cholesterol, high blood pressure, obesity, smoking, diabetes, and a family history of heart attacks. Symptoms of a heart attack often include chest pressure, sweating, pain radiating to the arms, shortness of breath, and nausea.
In contrast, sudden cardiac arrest is an electrical problem affecting the heart, leading to a dangerously fast heart rhythm. It results from the heart’s electrical malfunction, causing a halt in blood flow to the body and brain. Risk factors for sudden cardiac arrest include a low ejection fraction, heart failure, a history of a previous heart attack, or a family history of SCA. Unlike a heart attack, sudden cardiac arrest often occurs without warning. In some cases, other signs and symptoms may precede SCA, such as fatigue, fainting, blackouts, dizziness, chest pain, shortness of breath, weakness, palpitations, or vomiting.

The treatment for heart valve disease revolves around three primary goals: safeguarding the valve from additional damage, alleviating symptoms, and considering repair or replacement of the valves. Your doctor might suggest repairing or replacing your heart valve(s) even if you aren’t currently experiencing symptoms, as this can prevent enduring damage to your heart and reduce the risk of sudden death. The decision to undergo heart valve repair or replacement is influenced by various factors, including the severity of the valve disease, your age, and overall health. Opting for valve repair contributes to preserving the strength and function of the heart muscle.