Mr. Quynh, 68 years old, had aortic valve stenosis complicated by heart failure and could not have surgery due to many underlying diseases. The doctor replaced his heart valve through a catheter.
Mr. Quynh had aortic valve stenosis three years ago. The symptoms were not obvious. He lived normally. He only had a slight dizziness every time he changed position from sitting to standing. Occasionally, he had a tingling sensation in his chest that then went away. For the past three months, he has had difficulty breathing when exerting himself and has chest pain behind the sternum. He has been unable to do heavy labor. He went to Tam Anh General Hospital in Ho Chi Minh City for a check-up.
Prof. Dr. Vo Thanh Nhan, Director of the Interventional Cardiology Center, diagnosed a patient with aortic valve stenosis. This is a condition in which the valve does not open fully, preventing blood from being ejected into the circulation, reducing cardiac output and reducing blood flow to organs. The disease progresses silently over a long period of time, causing complications of stage 3 heart failure. If left untreated for a while, heart failure progresses to the final stage, with the risk of arrhythmia, endocarditis, and sudden death. If not treated at this stage, the prognosis of living over 2 years is only 50%, according to Professor Nhan.
Patients with many underlying diseases such as hypertension, heart failure, moderate aortic valve regurgitation, ischemic heart disease, and lipid disorders cannot have surgery due to many potential risks. The team applies the transcatheter aortic valve implantation (TAVI) technique because this is a minimally invasive method, the patient does not need to saw the sternum, reducing the risk of complications. New valves have a lifespan of up to 12 years.
Interventional doctors implant transcatheter aortic valves in patients. Image: Trung Vu
The patient’s aorta was slightly tortuous, making it difficult to pass the catheter from the femoral artery to the aortic valve. The aorta is still horizontal. If you use an old (self-expanding) valve, the operation will be difficult. The doctor uses a new generation valve (balloon dilation). The body of the catheter is quite soft so it can easily pass through winding blood vessels. After more than an hour, the new valve is placed in the correct position, taking on the role of transferring blood to the body. The patient’s heart function improved, shortness of breath, fatigue, and chest pain went away, and he was discharged from the hospital after three days.
Professor Nhan assessed that the new valve works well, the patient has less pain, and can perform normal tasks after about 4-6 weeks.
Professor Nhan asked about Mr. Quynh’s health on the second day after the intervention. Image: Minh Huyen
Professor Nhan said that SAPIEN 3 is the current generation of advanced balloon dilation valves. Compared to other TAVI valves, the SAPIEN 3 valve has high positioning accuracy. The compact size of the valve makes it easier for doctors to perform coronary intervention or place a new valve in the future, so seriously ill people have more opportunities to live healthy lives. Transcatheter aortic valve implantation (TAVI) is a difficult technique. If not handled skillfully, it can easily lead to unintended risks such as bleeding, embolism, and aortic rupture causing death. This technique has been approved by health insurance, giving patients the opportunity to be treated with modern methods at a reasonable cost.