Transcatheter Aortic Valve Implantation
Until the year 2002, aortic valve replacement, i.e. replacing the main valve of the heart when it is severely obstructed by calcium accumulation was performed only through open heart surgery by a Cardiovascular Surgeon. In that year, French Dr. Allan Cribier, successfully performed the first implantation of an Aortic Valve through Transcatheter Aortic Valve Implantation (TAVI) antegrade, that is via transseptal puncture. This procedure was initially performed in a very sick patient who had been rejected for surgical resolution. The patient improved his cardiovascular symptoms and hemodynamic parameters of the newly implanted aortic valve. However, the patient later died from complications related to multiple pathologies that he suffered. This pioneering procedure paved the way for that in 2005, a randomized study was published and showed that the Transcatheter Aortic Valve Implantation was an option for very sick patients who had been rejected for surgical resolution. Currently this procedure is being done in our country, via retrograde transfemoral approach, involving a multidisciplinary team that includes: Interventional Cardiologists, Cardiovascular Surgeon, Echocardiographer Cardiovascular Anesthesiologist, Cardiopulmonary Technicians, Hemodinamists Nurses and Clinical Transcatheter Aortic Valves Specialists; and in Hospital Privado Centro Médico de Caracas, we have had the opportunity to perform it successfully in several selected patients. Notably, the patient may reinstate earlier to a normal life after a TAVI procedure and requires an average hospital stay of 72 hours with only 24 hours in ICU. One of the key elements for choosing this method of treatment is to properly select the patient for the valvular implant.
