Updated on 6 September 2012
TAVI by Endoluminal Sciences, Australia, ensures faster recovery
Endoluminal Sciences, an Australia-based company, is developing a breakthrough technology for the treatment of failing heart valves. This technology has the potential to treat patients with heart valve disease without the complex and invasive open heart surgery.
Aortic stenosis (AS) is a common disorder, particularly among the elderly, where the aortic valve undergoes degeneration and calcification as part of the aging process. In severe cases, the diseased valve barely opens, restricting blood flow from the heart to the body. This severely debilitating condition causes symptoms of breathlessness, dizziness, chest pain and extreme fatigue, leading to progressive heart failure and/or sudden death.
Surgical Aortic Valve Replacement (SAVR) is the standard care for the treatment of AS, which involves replacement of the diseased valve with valve prosthesis through an open chest surgery on the heart, a highly invasive and potentially traumatic procedure. However, a third of the candidates are considered too frail, due to advanced age and multiple co-morbidities, to undergo SAVR because of a high risk of complications and death. The prognosis for such patients deemed unsuitable for open heart surgery is about two years.
In recent years, Transcatheter Aortic Valve Implantation (TAVI) has been developed as a minimally invasive alternative for the treatment of AS. This procedure allows for the implantation of a valve bio-prosthesis in the place of the diseased native aortic valve by insertion of a catheter through a small hole in the groin or the chest, requiring local anesthesia and less time. It is done while the heart is still beating, leading to faster recoveries and shorter hospital stays.
Despite its significant clinical advantages over SAVR, TAVI, today, cannot cater to young patients who would not like to undergo traumatic and painful open heart surgery. The major limitation of this revolutionary therapy is the critical failure mode of leakage from around the structure of the implanted valve bio-prosthesis, known as paravalvular leaks (PVL), which occurs in a moderate to severe degree in 20-30 percent of the patients. As a result of this complication, part of the blood pumped into the aorta leaks back into the heart, which then has to be pumped out back again, exerting excess workload on the heart, weakening it and eventually leading to heart failure.
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