Heart disease is a double edge sword for the elderly population. The risk of severe heart disease increases manifold in old age, and may require an open heart surgery. However, there is a catch! Open heart surgeries are stressful for the body, as it literally involves cutting through the skin and performing surgery on the heart, and often prove high risk for the older population.
A study published in the Annals of Thoracic Surgery found that in the group of older adults, 33 out of 628 patients passed away within 30 days after treatment, and the overall death rate during the hospital stay was 6.4%. The study also found that the average length of time patients stayed in the hospital after surgery, among those who survived and were 70 years or older, was 11.6 days, whereas it was 8.5 days for patients under 70 years old. However, the most shocking finding was that the average hospital cost for patients 70 years and older was 114% of that for younger patients.
These are some of the reasons why the older generation tries to avoid cardiac surgery as much as possible. Although the study mentioned above was conducted almost two decades ago, and healthcare practices and technology has far evolved since then, the risk of open heart surgery still holds.
So how do we take care of our elders and their heart? One solution is the modern technology of Transcatheter Aortic Valve Replacement (TAVR). Talking to the OnlyMyHealth team, Dr Anup Taksande, Consultant Interventional Cardiologist, Wockhardt Hospital, Mira Road explained, “This minimally invasive and highly effective treatment option offers renewed hope for elderly patients suffering from heart problems by helping them avoid open-heart surgery.” To quash the doubts surrounding TAVR, Dr Taksande shared a recnt case of a 72-year-old woman who underwent a successful, life-saving TAVR procedure.
What Is The TAVR procedure?
Transcatheter Aortic Valve Replacement (TAVR) is a non-surgical procedure done in the Cath Lab and has proven to that it can minimise invasiveness and reduces the risk of morbidity and mortality. “The procedure is performed under mild anesthesia and is suture-less through the groin,” said Dr Taksande.
Calling it an innovative approach, Dr Taksande said, “elderly individuals are provided an opportunity to undergo life-saving treatment without enduring the rigours of traditional open-heart surgery.”
In a latest study published in the journal ‘Cureus’ researchers found that the long term survival rates after undergoing TAVR was as high as 73.5%. Talking about the hope that TAVR offers, Dr Taksande taked about Heera Mishra, a 72-year-old woman, who was considered a high-risk patient, due to her history of severe comorbidities, two strokes, a weak heart, and two angioplasties, a procedure to open blocked coronary arteries.
Also Read: Case Study: TAVR Heart Procedure Saves Life Of Two 85-Year-Old Patients; Know Details
Top Stories
-1751527287915.png)
-1751352905978.jpg)
The Battle Against Heart Disease
Heera Mishra's life took a turn when she suffered a major heart attack and then underwent two angioplasties in 2010 and 2014. Her health struggles continued as she was later diagnosed with a stroke in 2018, followed by another stroke in 2021. Her condition deteriorated further when she developed progressive narrowing in the aortic valve of her heart, which is one of the heart’s four chambers, last year.
Mishra was diagnosed with severe Calcified Aortic Valve Stenosis, which had caused her Aortic Valve to get narrow, causing the following symptoms:
- Dizziness
- Falls
- Chest discomfort
- Severe breathlessness
- Low Blood Pressure
Dr Taksande said, “This condition is commonly seen in the elderly over 65 years of age, who also have comorbidities such as coronary artery disease, stroke, and chronic obstructive pulmonary disease(COPD). Around 0.5% to 1% percent of the population above 65 years of age suffers from Calcific Aortic Valve Stenosis. In severe cases, it causes sudden cardiac arrest that can cause death.”
“On arrival, the patient was in critical condition. Our focus was mainly on the aortic valve which was getting narrow. Her tests showed that the valve, was not fully opening, blocking the blood to flow to the body,” he added.
Also Read: True Story: 95 Year Old Allwyn Almeida Receives TAVR Treatment Post Covid Recovery
A True Story of TAVR Success
Heera Mishra got a fresh lease of life after the doctors performed the TAVR procedure for her Valve disease, sparing her from open heart surgery, thus preventing sudden cardiac arrest.
According to the American Heart Association, here’s what happens during a TAVR procedure:
- Preparation: The patient is prepared by administering anesthesia, usually general anesthesia or conscious sedation.
- Access: A small incision is made, often in the groin area, to access the blood vessels.
- Guidance: Using advanced imaging techniques such as fluoroscopy and echocardiography, a thin, flexible tube called a catheter is guided through the blood vessels to reach the heart.
- Valve Placement: Once the catheter reaches the heart, a replacement valve (often made of biological materials) is delivered to the site of the diseased valve.
- Expansion: The new valve is expanded into place, pushing aside the old, diseased valve.
- Functionality Check: The function of the new valve is assessed to ensure proper placement and functionality, often using imaging techniques to confirm adequate blood flow.
- Closure: After confirming the success of the procedure, the catheter is removed, and the incision site is closed.
Talking about the procedure, Dr Taksande said, “The uneventful procedure lasted for 30 minutes and the patient was shifted to the ICU for a day and made to walk after 12 hours of procedure. She was shifted to the ward for a day and then discharged in stable condition on 2nd Jan 24. The patient came after 10 days for follow-up. She was asymptomatic with no further complaints of giddiness or breathlessness."
Concluding Mishra’s case, her son Sujith Mishra expressed gratitude to the doctors and the TAVR procedure. He said, “My mother had a history of strokes and cardiac arrest, and now aortic valve stenosis, which was was just petrifying for us. This new year marks a fresh start for her as she managed to avoid open heart surgery through the use of TAVR. I am grateful to the doctors who saved my mother's life.”