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Open "Heart　Minimally Invasive Surgery without Chest Opening

Open your heart!　

Traditional heart valve surgery is performed through extracorporeal circulation and sternotomy, but technological advances have led to minimally invasive transcatheter aortic valve replacement surgery, which significantly reduces the risk of open heart surgery; Chi Mei Medical Center has established a Transcatheter Aortic Valve Replacement (TAVI) team at the end of last year, which has already completed four cases.

Aortic valve stenosis and heart failure

The aortic valve is located between the left ventricle and the aorta, and it must be fully open when the left ventricle contracts to allow blood to flow smoothly out of the left ventricle into the aorta, sending oxygen-rich blood throughout the body. The aortic valve may not be able to open smoothly due to congenital or acquired reasons and becomes a narrow opening, which is called "aortic stenosis".

With a narrowed aortic valve, the left ventricle needs to work very hard to push blood through the aortic valve. In the early stages of the disease, patients are asymptomatic, but as the aortic valve narrows, the left ventricle becomes more hypertrophied and fails, and the patient experiences angina pectoris, fainting, and even wheezing, edema, and other symptoms of heart failure.

The traditional surgical treatment of aortic valve stenosis is a surgical replacement of the aortic valve, and the traditional surgical procedure involves cutting open the sternum and taking a long time to perform the surgery, which is not something that many older patients are willing to do, or that the surgeon feels is not suitable for the patient. The patient's heart is not in the right place for surgery, and many patients have to live with angina and heart failure for the rest of their lives.

As a result, the survival rate of patients begins to decline significantly from the onset of symptoms, averaging about 5 years from the onset of angina to death, 3 years from the onset of syncope to death, and 2 years from the onset of symptoms of heart failure to death; more than half of aortic stenosis is due to calcification of the valves due to aging, and the prevalence rate is about 4% in older people aged 85 years or older.

Transcatheter Aortic Valve Replacement (TAVI): Small Wound, Fast Recovery, and Good Cure

According to Dr. Chung-Ching Chiu, President of Chi Mei Medical Center, a new type of treatment that has emerged is Transcatheter Aortic Valve Replacement (TAVI), which involves placing a stent through a catheter to open up the diseased valve to the outside. TAVI is a catheterized valve stent that is inserted into the aortic valve to open up the diseased valve, allowing the implanted valve to replace the original valve and restore normal function. This procedure, with its small wounds and quick recovery, has led to an increase in the number of patients undergoing TAVI around the world, especially for those who would otherwise not have been able to undergo traditional open heart surgery due to the high risks involved.

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