Valve prostheses are devices that try to alleviate the symptoms that a heart valve in poor condition, either stenotic or insufficient, generates. Dr. Martín Reyes, an expert in Cardiology, talks about these prostheses and their advantages.
Types of valve prostheses
There are basically two types:
– Mechanical valves are used mainly in younger people with the aim of greater durability but with the problem of requiring lifelong anticoagulation, with the potential risks involved.
– Biological aortic valve prostheses can currently be implanted without the need for sternotomy (conventional cardiac surgery). This transcatheter aortic valve implantation (TAVI), known as transcatheter aortic valve implantation (TAVI), is performed in most cases percutaneously through the femoral artery. Currently there are two types of TAVI widely studied: o Balloon expandable: Sapien valve ®, Edwards. o Self expandable: CoreValve ®, Medtronic.
Application of valve prostheses
Transcatheter aortic valve implantation has become the treatment of choice for patients with symptomatic severe aortic stenosis considered inoperable, with better results than conservative management, including aortic valvuloplasty. The first indications were in very high-risk patients considered inoperable. Thanks to the results of relevant clinical studies recently published in the New England Journal of Medicine, it has been demonstrated that, even in patients with moderate surgical risk, percutaneous aortic prosthesis implantation is as effective as standard cardiac surgery. This broadens the spectrum of patients who can benefit from this technique, without the need to undergo cardiac surgery.
Advantages over conventional cardiac surgery
The main advantage is that it is a new minimally invasive procedure to treat symptomatic aortic stenosis. As it is a minimally invasive surgery, the advantages are:
– Shorter recovery of one or two days.
– As it is minimally invasive, it does not require an incision in the chest.
– It is less painful than conventional open surgery
– It is a life-saving option for high-risk patients.
Risks of valve prosthesis surgery
The main risks are those inherent to the vascular puncture site. There may also be complications such as stroke or the need to implant a pacemaker permanently. Mortality is low. Currently, the latest generation TAVis are being implanted in the Hospital La Luz, which reduces the rate of vascular complications and the need for a definitive pacemaker.