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TAVR and Other Options for Heart Valve Repair and Replacement


Vejthani Hospital offers several heart valve repair and replacement surgery options, including the latest minimally invasive transcatheter aortic valve replacement (TAVI/TAVR).  

Are you constantly out of breath and fatigued, even after getting a good night’s sleep? These are both symptoms of heart valve regurgitation. This condition occurs most commonly in either the mitral valve or aortic valve. In both cases, the heart valve fails to prevent blood from flowing back in the opposite direction when the leaflets that control blood flow are contracting. This leakage or back flow reduces blood supply to organs and overloads the heart, causing it to work harder.

Heart valve regurgitation is a condition that may appear suddenly, or it may take several decades to develop.

There are two choices for treatment of this condition, and both of them require surgery. The two choices are to repair or replace the heart valve. Whenever possible, doctors choose to repair a patient’s own heart tissue. But when the tissue is too damaged to be expected to ever function properly, the only option left is to replace the heart valve. This replacement valve may come from a human donor, an animal, or they may use a mechanical valve. The patient may also be eligible to have the less invasive TAVI/TAVR procedure performed, which minimizes risks and offers a quicker recovery time. 

Repair Surgery for Heart Valve Disease

To repair a mitral valve that’s become too narrow and rigid, a balloon valvuloplasty procedure may be used. It is a less invasive procedure than general or open-heart surgery, but can offer a less predictable result.

A small catheter is threaded into the heart. This catheter holds an expandable balloon that’s placed into the tightened valve. The balloon is then expanded and stretches the valve open, and separate the leaflets at the opening of the valve.

This is the best-case option. For cases that don’t respond to this procedure, another, more invasive procedure is necessary to open the valve and increase the blood flow by open-heart surgery. The operation of choice would be mitral valve repair if it is possible.

Replacement Surgery for Heart Valve Regurgitation

In cases where the doctors don’t feel that the heart valve can be repaired effectively, the other option is to replace the valve entirely.

There are several accepted procedures that a doctor can choose from based upon the condition of the heart valve, the severity of the symptoms and the risks posed by the surgery. These options include either a human or a biological (animal) valve replacement, or a mechanical valve replacement. This is what’s called a Ross Procedure. It involves switching a healthy valve into the position of a damaged aortic valve. The final option is a TAVI/TAVR procedure, a Transcatheter Aortic Valve Replacement used in aortic heart valve stenosis. The TAVI/TAVR procedure offers a much less invasive procedure than open-heart surgery. 

Needs of the Patient

The patient will be informed which option is best for them, either repair of the existing valve or replacement by either open-heart or TAVI/TAVR surgery. The doctor will keep the patient fully informed of the options and their recommendations for success. Vejthani Hospital in Bangkok is highly skilled in performing both repair and replacement surgery; it’s one of the most experienced hospitals performing TAVI/TAVR surgery in Thailand. Contact Vejthani Hospital at your earliest convenience if you’re experiencing symptoms of aortic valve disease.

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