Trans Aortic Valve Replacement Surgery in Turkey
Trans Aortic Valve Replacement Surgery in Turkey is an article that aims to give you all the information you do not know about Trans Aortic Valve Replacement Surgery in Turkey and more. We kindly shared the main headings with you;
What is trans aortic valve replacement (TAVR)?
A minimally invasive heart treatment called trans aortic valve replacement or transcatheter aortic valve replacement (TAVR) is used to replace an inadequately functioning thickening aortic valve (aortic valve stenosis). The body’s main artery and the left lower heart chamber are where you’ll find the aortic valve (aorta). Reduced blood flow from the heart to the body results from improper valve opening.
The indications and symptoms of aortic valve stenosis, such as exhaustion, shortness of breath, fainting, and chest pain, can be lessened by TAVR by restoring blood flow. Transcatheter aortic valve implantation (TAVI) is the other name for this surgery.
What is the purpose of the surgery?
Treatment for aortic valve stenosis is transcatheter aortic valve replacement (TAVR). When the heart’s aortic valve thickens and stiffens, it develops aortic valve stenosis, also known as aortic stenosis (calcifies). The valve can’t fully open as a result, and the body receives less blood flow. Aortic valve replacement surgery with an open heart is an alternative to TAVR. TAVR frequently results in a shorter hospital stay than surgical aortic valve replacement.
Who are the ideal patients for TAVR?
People at risk of problems following surgical aortic valve replacement may be good candidates for TAVR (open-heart surgery). A team of heart and heart surgery specialists who collaborate to find the best treatment for you will review your options before deciding whether to treat your aortic stenosis with TAVR.
If you have conditions as follows this surgery may be the best option for you,
- Indications and symptoms of severe aortic stenosis.
- A biological tissue aortic valve isn’t performing as well as it should.
- Another medical problem that makes open-heart valve replacement surgery too dangerous, such as lung or kidney disease.
Even though TAVR has a lot of advantages, not everyone should have it. The following are some situations where TAVR wouldn’t be suggested,
- A life expectancy of less than a year
- Specific congenital cardiac valve abnormalities
- Significant valve calcification
- Endocarditis
- Insufficient site for vascular access
How to prepare for the surgery?
On how to get ready for transcatheter aortic valve replacement, the medical staff will give instructions (TAVR). Beforehand make sure you know,
- The procedure’s name
- The reason behind your treatment
- What outcomes to anticipate and what they signify
- The procedure’s advantages and disadvantages
- What problems or negative effects might occur
- When and where the surgery will take place
- Who will do the treatment and what credentials they possess
- What would occur if the surgery wasn’t done
- Any potential alternatives to consider
- Who to contact if you have inquiries or issues following the procedure
- How much the surgery will cost
If you have any inquiries about the operation, talk to your doctor. Consult your doctor about,
- When and when you can take your typical medications prior to a TAVR operation
- What time before the surgery you should stop eating or drinking
- Any medication allergies you may have
Several items, such as the following, may be suggested by your medical team for you to bring to the hospital,
- A list of each medication you use, including over-the-counter drugs, hearing aids, dentures, or eyeglasses
- Items for personal care, including a brush or comb, a toothbrush, and shaving supplies Comfortable, loose-fitting clothing
- Things that could make you feel more relaxed, including books or portable music players
What are the advantages of TAVR?
The TAVR procedure has a number of advantages over other procedures, such as open heart surgery. For instance,
- TAVR is minimally invasive, requiring a considerably smaller incision.
- Usually necessitates a shorter hospital stay, and a quicker recovery time.
- Can be used in patients with high surgical risk
- May improve health and quality of life in patients who would not have had many options for valve repair
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What are the risks of the surgery?
Leaks from valves: Blood leaks around the new valve from time to time because the replacement was either too small, did not fully expand, or was obstructed by calcium accumulation. Issues with the replacement valve, including leaks (regurgitation) or slipping out of position are also among the concerns.
Arrythmias: When valves open during implantation, they may occasionally put pressure on the heart’s electrical circuitry, necessitating the use of a pacemaker. The need for a pacemaker also results from heart rhythm problems which are called arrhythmias.
Damage to kidneys: The contrast dye used for imaging can harm your kidneys, although the condition is typically treatable.
Vessel damage: Your arteries may be harmed if catheters are inserted through them. Typically, open vascular surgery or a catheter can be used to heal the injury.
Stroke: A tiny number of TAVR patients have experienced a stroke either during the procedure or in the days that follow.
What to expect?
Before the operation
Make sure to remove any,
- Contacts
- Dentures
- Eyeglasses
- Accessories
- Nail polish
Your hand or forearm will be used to place an IV, and a specialist may also provide a sedative to help you unwind. Through the IV, anticoagulant medication can also be administered. Additionally, you can be given medicine to lower your risk of infection. The area of your body where the treatment will be performed can have hair removed.
The surgery
The surgery lasts about 90 minutes. Using an artificial aortic valve produced from cow or pig heart tissue, transcatheter aortic valve replacement (TAVR) replaces a damaged aortic valve (biological tissue valve). Sometimes the biological tissue valve is inserted into a biological tissue valve that already exists but is no longer functional.
A catheter is inserted into a blood vessel, typically in the groin or chest area, and guided into the heart during TAVR by a medical professional. The doctor can position the catheter correctly with the aid of moving X-ray or echocardiography images.
Through the hollow catheter, a substitute aortic valve consisting of cow or pig tissue is inserted into the affected area.
The replacement valve is forced into place by the inflation of a balloon at the catheter’s tip. Some valves can open without a balloon. After the new valve is placed firmly, the catheter gets removed.
The medical staff will closely monitor your vital signs throughout the TAVR surgery, including blood pressure, heart rate and rhythm, and respiration.
After the operation
After your procedure, you can spend the night being monitored in the intensive care unit (ICU). The length of your hospital stay following TAVR is determined by a variety of factors. Usually, the hospital stay is between 3-5 days however, some patients with TAVR return home the following day. Your medical staff will go over aftercare instructions and how to look out for infection symptoms before you leave the hospital such as,
- Fever
- Worsening pain
- Presence of redness, swelling, draining, or leaking at the catheter site.
Following TAVR, a number of drugs could be prescribed like blood thinners (anticoagulants) or antibiotics.
Blood Thinners (Anticoagulants)
Blood clots are prevented by taking blood-thinning medicines. You’ll hear from your doctor about how long you might need to take this medication. Take your meds exactly as directed.
Antibiotics
Artificial heart valves are susceptible to bacterial infection. The majority of bacteria that result in heart valve infections originate in the mouth. Regular dental cleanings and good oral hygiene can help stop these illnesses. Some dental treatments call for the administration of antibiotics beforehand.
In order to give the incisions time to heal, we urge patients to refrain from driving for at least 72 hours after the procedure and to avoid intense exercise for 10 days. TAVR recovery is quicker in contrast to open-heart surgery recovery. Another point that makes TAVR preferable is that it allows the patient to return to his regular life just only after 2 weeks.
When to call doctor?
After TAVR, the new valve must undergo regular medical examinations and imaging testing to ensure that it is functioning appropriately. Let your doctor know if you experience any new or deteriorating signs or symptoms, such as:
- Dizziness
- Swollen ankles
- Unexpected weight gain
- Extreme fatigue after exercising
- Infection symptoms or signs
Obtain immediate medical assistance if you have:
- Chest pressure
- Tightness, or discomfort
- Severe, unexpected breathlessness
- Fainting
How to maintain long-term results?
To observe the effectiveness over a certain period of time follow-ups play a crucial role. Therefore, following TAVR, follow-up echocardiography should be done before discharge (or within 30 days of the procedure), at 6, 12, and subsequently yearly (13) for surveillance.
Aortic valve stenosis symptoms and indicators may be reduced with transcatheter aortic valve replacement (TAVR), which may enhance the quality of life.
Maintaining a heart-healthy lifestyle is crucial as you heal and can help stop further heart issues. In order to achieve this,
- Avoid smoking.
- Consume a healthy diet reduced in salt (sodium), saturated and trans fats, and abundant in fruits and vegetables.
- Get regular exercise; before beginning a new fitness program, see your doctor.
- Keep a healthy weight.
What is the difference/similarity between surgical aortic valve replacement (SAVR) and TAVR?
Contrary to surgical aortic valve replacement, which necessitates a lengthy incision through the chest (open-heart surgery), TAVR is performed using smaller incisions and a thin, flexible tube (catheter) to access the heart. Additionally, according to a recent comparison of TAVR and surgical aortic valve replacement using real-world data from nationwide databases, the two procedures offer comparable one-year survival rates and rates of stroke in intermediate and high-risk patients, but TAVR patients were more likely to be discharged to home following their procedure than SAVR patients which makes it more cost-efficient.
According to medical literature, the tissue valves utilized in surgical aortic valve replacement typically have a lifespan of between 10 and 20 years. Since TAVR valves are constructed from the same biological tissue, the same lifetime is anticipated.
What are the alternatives and approaches of TAVR?
Transcatheter aortic valve replacement (TAVR), which treats aortic stenosis without requiring open heart surgery, has changed many people’s lives in the relatively short period since it was approved. The femoral artery, the conventional approach for TAVR, may not be suitable for all patients.
The femoral and iliac arteries may constrict in patients with aortic stenosis and coronary disease. Their leg arteries may be too tiny to enter the catheter needed to deliver the transcatheter valve because of this constriction.
Alternative methods of accessing the aortic valve have been created with the intention of making TAVR accessible to everyone who requires surgery.
Transapical TAVR (TA)
The first approved alternative, transapical TAVR, necessitates a 3 to 5-inch incision in the left nipple of the chest. The aortic valve can then be directly accessed through the left ventricle by means of a small incision made by the surgeon at the top of the beating heart. However, research has shown that passing through the apex of the heart has risks, including hemorrhage and momentary disruption of left ventricular function.
Transvaal (TCv) Approach
By utilizing the femoral vein, the Transvaal (TCv) method is a cutting-edge surgical solution that minimizes artery disease. In order to execute TAVR, surgeons first create a wire and electrical cautery pathway from the inferior vena cava to the abdominal aorta. A little plug is then given to close the passage after the valve has been installed.
Transaortic (TAo) Approach
In order to install the valve, surgeons make a small incision close to the sternum. It frequently requires resecting (cutting out) the sternum or rib to gain access to the heart.
Transcarotid Approach (TC)
When individuals are ineligible for transfemoral access (going through the femoral artery or being carried out via it), a more recent technique known as the transcarotid method has gained popularity.
Trans-subclavian Approach
The axillary subclavian artery is the second alternative artery that is utilized, and it may be preferred. A small incision made close to the collarbone exposes the subclavian artery, which is then used to guide a catheter past the constricted aortic valve and into the aorta.
What is the cost of TAVR surgery in Turkey?
You may ask yourself “What is the cost of trans aortic valve replacement surgery in Turkey?”. The TAVR patients pay around $19,000 or more for their surgeries as a first step. This is undoubtedly influenced by the expensive TAVR valve. But for the balance of the hospitalization, TAVR surgery in Turkey reduces hospital stays by around four and a half days, including the two days spent in the intensive care unit. This short hospital stay results in significant cost-saving. Another $2,600 in cost savings with TAVR occurs over the following two years, most of which is attributable to decreases in rehabilitation and rehospitalization expenses that happened within the first six months of follow-up.
In patients with severe aortic stenosis and low surgical risk, comparing transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR), despite higher procedural costs, quality-adjusted life expectancy is higher and total costs are lower with TAVR at 2-year follow-up, making TAVR cost-effective for the patients at that point according to a recent study that was conducted.
Today, the TAVR surgery in Turkey procedure including hospitalization and follow-ups costs between $40,000 and $80,000.
Trans Aortic Valve Replacement – TAVR Surgery in Turkey Summary (Price, Duration Time, Hospitalization)
Operation Number | 1 | Time to return to work | 3 days |
Operation Time | 1.5 hours | Recovery | – |
Anaesthesia | General Anaesthesia | Persistence of Results | 10-20 years |
Sensitivity Time | 10 days | Hospital Stay | 3-5 days |
Price | From 40,000 EUR to 80,000 EUR |