Catheter valve implantation cuts risk for elderly patients 二次「開心」風險高 九旬嬤經導管置換瓣膜救命

Sat, Apr 30, 2016 - Page 10

An elderly woman surnamed Chiang who is 92 years old underwent an open-heart surgery for aortic stenosis 10 years ago. Since the useful life of an implanted valve is limited to about 10 years, she needed to have a new valve implanted. If done by conventional surgery, the mortality rate for a second operation of this sort would be 10 to 20 percent. However, the Cheng Hsin Hospital used transcatheter aortic valve implantation (TAVI), in which there is no need to “open the heart.” Instead, a catheter is used to implant the valve via the femoral artery.

Yin Wei-hsian, chief of Cheng Hsin Hospital’s Division of Cardiology, says that aortic stenosis usually occurs in elderly people aged 65 or older. As people get older, the aortic valve may become hardened, calcified or narrowed, causing decreased blood flow, which may in turn lead to symptoms such as heart failure, angina and fainting.

Wei Jeng, chief of Cheng Hsin Hospital’s Heart Center, points out that the conventional approach to aortic stenosis requires implanting a valve by means of open-heart surgery, but if the patient is over 80 years old and has undergone an implantation in the past, most doctors will generally refuse to operate on them because the surgery is too risky.

Yin says that TAVI requires a smaller incision and a much shorter surgical procedure, and the patient can get out of bed on the same day, while the operation carries a risk of less than 3 percent. The only problem is that the National Health Insurance scheme currently does not pay for this procedure, so patients have to pay around NT$1 million out of their own pockets to have it done.

Since performing its first TAVI in 2013, Cheng Hsin Hospital has carried out this procedure on more than 150 patients whose average age is 83, and the oldest of whom was 101 years old.(Liberty Times, translated by Julian Clegg)