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How treatment of cardiovascular disease has evolved

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Valve replacement is now possible from the TAVR without open chest surgery. ShockWave Lithotripsy is highly effective in calcified blockages, says a heart specialist

December 21, 2020 (IANSlifeAccording to an estimate, at present 4.77 million people die in India due to cardiovascular disease, and this number is increasing rapidly. New treatment techniques have come up to make the treatment much easier for those patients who are unable to undergo open chest surgery due to old age or other issues.

World class techniques are now available in India for the treatment of severe heart disease like aortic stenosis or dangerous calcified blockages in the coronary artery, says Dr Ravindra Singh Rao, Specialist, Structural Heart Disease, Jaipur.

Heart valve will change without surgery 

About three lakh patients in India do not undergo open chest surgery due to old age or other health related problems. In such a situation, TAVR technology can prove to be a boon for them, believes the doctor. Till now the patient underwent major open chest surgery at the contraction of the aorta valve. It took time of several days for the patient to recover after surgery. But now the Transcatheter Aorta Valve Replacement procedure can replace the patient's valve without a single cut on the body or any major surgery of the patient. For this, an artificial valve can be reached up via catheter (simply using a flexible tube inserted through a narrow opening into a body cavity) from thigh vein to the aorta and the artificial valve can be implanted. In just one to one and a half hours this procedure is completed and on the next day of the procedure, the patient starts moving.

 

Dr Ravinder Singh Rao

 

This technique does not have all the risks as in an open heart surgery and the patient can get discharged from hospital in just 4-5 days prior to the procedure. He may soon return to his normal routine. Whereas after open chest surgery, it takes about six months to one year for the patient to recover completely, says Dr Ravindra Singh Rao.

When calcified blockage occurs now, Shock Wave Lithotripsy Angioplasty is an alternative of bypass surgery

Heart blockages occurring in about 90 percent of men and 67 percent of women over the age of 70 are of calcium. Until now, bypass surgery was the only means to correct these blockages, but Shock Wave Lithotripsy Angioplasty Technique has come now as an option to treat patients. It is now possible to insert stents through intervention by doing Angioplasty. This will be helpful for those patients who do not have the capacity to bear bypass surgery. Until now, it was very difficult to perform stenting from interventions in arteries with calcified blockages as there is a 30 to 50 percent risk of re-closure or rupture of arteries after stenting.

Shock wave lithotripsy is a sonographic technique. In this technique, calcium is broken through a sonographic wave and a stent is inserted. This causes no damage to the artery and fine particles of calcium become part of the artery. Angioplasty with this technique takes 45 minutes to an hour and the chances of recurrence of blockage remains about five to seven percent only.

 

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