A minimally invasive procedure called transcatheter pulmonary valve replacement (TPVR) is used to replace a malfunctioning pulmonary valve in the heart. Rather of opening their chest during surgery, a surgeon does the treatment through tiny skin incisions in the groin.
The pulmonary valve is important because it regulates the flow of blood from the heart to the lungs. People with congenital heart disease who had surgery as children will frequently experience problems with their pulmonary valve as adults. Replacing a failing pulmonary valve can have a significant impact on lifespan and quality of life, as well as prevent or delay repeat surgeries.
Patients with congenital cardiac disease may require fewer surgical procedures and recover more quickly after TPVR. Both surgical pulmonary valve replacement and TPVR have the risk of valve wear out over time necessitating a second procedure. In the future, if necessary, a repeat TPVR is possible. Patients should weigh the advantages and disadvantages of TPVR vs surgery with their healthcare provider.
Pulmonary conditions that the patient have includes the following:
If a patient has congenital heart disease that affects their pulmonary valve, they may benefit from TPVR. Individuals with congenital heart disease who have pulmonary valve surgery as children may experience pulmonary regurgitation or stenosis in their early adult years. Surgeons frequently used homografts, also known as allografts, to replace pulmonary valves. This is a donated human heart’s pulmonary valve. Over time, this homograft may fail, and the most frequent reason why healthcare providers would think about TPVR for a patient is pulmonary homograft failure.
If the patient has a history of any of the following diseases, TPVR can help to improve and correct blood flow through the heart:
Individuals who have had aortic stenosis treated with the Ross procedure may also experience pulmonary valve failure and benefit from TPVR.
The catheter insertion site may cause pain, bruising, or swelling for the patient. Risks could include:
Heart attack, stroke, or even death are uncommon complications of transcatheter pulmonary valve replacement.
For some patients with a malfunctioning pulmonary valve, healthcare providers may recommend TPVR over open heart surgery.
Cutting through the chest bone and putting the patient on a heart-lung bypass machine are necessary for surgical pulmonary valve replacement. A new pulmonary valve is implanted in place of the failing one by a surgeon. In certain cases, surgery is too dangerous, and recovery periods are longer.
Opening the chest is not necessary for transcatheter pulmonary valve replacement, which is a minimally invasive procedure. Rather, an interventional cardiologist uses X-ray guidance to make tiny incisions in the patient’s groin to advance a replacement valve from their leg vein to their heart. A surgeon places the new valve in place of the old one after it is in the proper position. This condition reestablishes the circulation of blood from the heart to the lungs, reduces the workload on the heart, and enhances the oxygen supply to the body. After this treatment, patients typically return home the next day.
The healthcare provider evaluates the patient’s health and cardiac function through a physical examination and exercise stress test to decide if TPVR is the best course of action. The patient might also have diagnostic procedures done, such as:
The healthcare provider may decide to monitor the heart over time (watchful waiting) or recommend TPVR based on the results. The patient and the healthcare provider will discuss the best course of action for their condition.
Before the procedure, the patient will receive specific instructions from their healthcare provider, outlining details such as the designated time for eating and drinking, recommended attire for the day of the procedure, and guidance on which medications to either discontinue or adjust.
Patient should inform their healthcare provider of any allergies they may have and provide details about supplements or medications they are taking, including blood thinners (anticoagulants) or nonsteroidal anti-inflammatory drugs (NSAIDs). This information ensures that the healthcare team can make well-informed decisions tailored to the individual’s health and well-being during the upcoming medical intervention.
The cardiologist who will perform transcatheter pulmonary valve replacement will do the following:
The procedure will takes around two to three hours to finish.
The patient will be observed overnight following the procedure and discharged the next morning. To help in the patient’s recovery, the healthcare provider provides them with detailed care instructions.
Most patients are able to resume their regular activities within seven days. Ask for any further questions or concerns from the healthcare professional.
Compared to open-heart surgery, transcatheter pulmonary valve replacement has a number of benefits, including as a quicker recovery period, a lower risk of infection, shorter hospital stays, and fewer incisions and scars. For those having this cardiac treatment, these advantages add to a more efficient and possibly less invasive experience.
The heart health and general health are two of the several factors that affect how long the valve lasts. To repair their pulmonary valve, some patients might need to have another surgery.
Infections can result from dental procedures that releases germs into the blood. Inform the dentist ahead of time of the pulmonary valve replacement. Before their dental appointment, the patient might need to take medication.
To have an excellent result, follow to the instructions given by the healthcare provider and show up on time for the follow up appointments. If the patient has any unexplained discomfort, fever, or other symptoms following TPVR surgery, get in touch with the healthcare provider.
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