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Improving heart outcomes with TAVR

Improving heart outcomes with TAVR
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Cardiologist Prashant Patel, MD discusses the TAVR heart procedure

We need to first recognize aortic stenosis in order to treat it. Aortic stenosis is an underdiagnosed issue and one of the most mortal cardiac diagnoses that can be made. Once a patient develops symptoms (shortness of breath, dizziness, passing out, or swelling of limbs) they have a 50% chance of dying within 2 years … at the onset of symptoms. Often cardiologists see patients when they are already in the hospital and they are often beyond their 50% survival timeframe. When patients get hospitalized due to aortic stenosis the window for treatment becomes much smaller. 

content-imgPositive health news for seniors suffering from heart disease
This disease is predominantly a disease of our senior citizens. The classic age is in the range of '70s and '80s and that may be why it hasn't been aggressively dealt with because until recently our only options were surgical procedures. Many patients don't want open-heart procedures and they don't often do well in later years, which is why TAVR was developed to begin with. This specific inter-mediate valve, "the Edwards Valve," is a fantastic valve and is currently in its 3rd generation. The catheters continue to get smaller than when this procedure first became available in 2006. The smaller size has opened it up to more patients. It is now becoming the standard of care for the majority of "qualified patients." Most patients in their 70s and above, who are not low risk, will qualify for a catheter-based approach and the mortality benefit is clearly better with high-risk patients. At this time, TAVR is not approved for low-risk patients by most insurance carriers.

Early signs of low hospital readmission rates emerging with TAVR
Early indications are positive … showing patients are doing well with no readmission for heart failure, which is a huge feat since most of these patients were previously in the hospital at one point or another. Some patients were treated multiple times the year prior to their procedure. 

TAVR requires less recovery time
Today you can actually perform these cases with the patient awake or with low anesthesia. We can use general anesthesia and patients do very well. The overall recovery time is about a month following the procedure, but patients can expect to feel better immediately after the surgery. The next day they are normally up and walking and they usually return home sooner. We advise no heavy lifting, which is nothing heavier than 10 pounds for 7-10 days to allow incisions to heal. Patients still need to be careful because they don't get the shortness of breath or feel dizzy like before their procedure, so they want to start doing things they used to right away. I tell them to let their body catch up before overdoing it. 



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