The heart is an organ that needs good care because abnormalities may be hidden and symptoms appear as one gets older when everything deteriorates. Bangkok Heart Hospital is prepared to treat heart disease patients, revealing techniques for repairing or replacing heart valves without having to undergo open-chest surgery (TAVI/TAVR) for elderly patients at high risk of treatment, allowing them to live confidently again.
Dr. Rapin Kukreja, Cardiologist and Cardiovascular Interventionalist at Bangkok Heart Hospital says, “Society today has increasingly become an aging society. Diseases associated with aging, such as deterioration of blood vessels and valves, which become stiff, less elastic, and accumulate fat and calcium, make the heart valves unable to open or close properly. This leads to severe valve stenosis, which is commonly found in the aortic valve, the valve between the left ventricle and the main artery, making the heart unable to pump blood efficiently throughout the body, resulting in easy fatigue, weakness, and frequent fainting spells, forcing the heart to work harder, leading to heart wall thickening and ultimately heart failure.”
Studies of these patients show that over 80% of patients treated with medication alone die within 3 years, and those who survive live with difficulty, unable to take care of themselves. These patients often have other chronic diseases, such as diabetes, hypertension, emphysema, etc., which greatly increases the risk of death from open-chest valve replacement surgery. To improve these patients’ quality of life, to allow them to live happily with their families and descendants, a treatment method of valve replacement without open-chest surgery has been developed. It involves a heart catheter with an artificial heart valve at the tip, inserted to replace the old valve that is not functioning properly, allowing the heart to pump blood normally to various parts of the body.
Dr. Kosin Thupvong, Senior Director of Cardiac and Thoracic Surgery at Bangkok Heart Hospital reveals, “TAVI is a catheter-based valve replacement procedure without the need for major surgery. It is suitable for elderly patients around 80 years old and patients who are at high risk for surgery, have severe valve stenosis, poor lung condition, previous heart surgery, or very stiff major blood vessels. Most of these patients have aortic valves (Aortic Valve), patients without options, or those with complicated treatments due to initially not being eligible for surgery because of the high risks.”
The principle of TAVI uses a tissue-based valve attached to a special coil, which can be compressed into a small tube about 8 – 10 millimeters in a delivery system, then the delivery system is inserted through the blood vessel in the groin to the top of the left ventricle of the heart, reaching the position of the aortic valve. The valve is then released from the delivery system, allowing it to expand into a new valve while the patient has small incisions either on both groins or on the left or upper right side of the chest.
The advantages of TAVI treatment include improved quality of life and faster recovery because of less pain from the incision, reduced anesthesia, and lower treatment risks and complications such as infection, kidney failure, and reduced mortality risk.
Beyond techniques and doctors’ experience, another important aspect is the use of modern equipment and tools. Bangkok Heart Hospital chooses to perform TAVI in a Hybrid OR, combining the capabilities of a catheterization lab and heart and blood vessel surgery room in one, using a X-ray machine that can rotate and move 360 degrees, equipped with Flex Move Heart Navigator system and Heart Navigator software, capable of detailed heart imaging from all angles for smooth surgery or procedure in case of complications arising from catheterization or inserting the coil into the large blood vessel can immediately undertake surgery without having to move the bed or room.
Bangkok Heart Hospital is committed to bringing technology and innovation to enhance the efficiency of health and life care for heart disease patients, taking care of patients’ hearts to their full potential, for a better quality of life.”
