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In patients who are deemed too high risk for open heart surgery, TAVI significantly reduces the rates of death and cardiac symptoms. [6] Until about 2017 TAVI was not routinely recommended for low-risk patients in favor of aortic valve replacement, however it is increasingly being offered to intermediate risk patients, based on studies finding ...
Another alternative for many high-risk or elderly patients is transcatheter aortic valve replacement (TAVR, also known as TAVI, transcatheter aortic valve implantation). Rather than removing the existing valve, the new valve is pushed through it in a collapsed state.
The choice between SAVR and TAVR often relies on the open-heart surgical risk and indications for other open heart surgeries (etc., coronary bypass, other valve dysfunction). The Bentall procedure is a type of surgical procedure when the aortic valve, aortic root, and ascending aorta are replaced in a single operation.
This is an option for high risk patients otherwise not a candidate for a traditional open procedure. The Endo-Bentall device is made up of three parts: a self-expanding transcatheter aortic valve (TAVR) + aortic endovascular stent graft (TEVAR) and wire-reinforced fenestrations. [13]
In bicuspid aortic valve anatomy, there is congenital fusion of two cusps. This fused cusp is exposed to higher than normal stress and will stretch over time as a consequence. This results in aortic valve regurgitation. Annular enlargement is very frequent in this context, and it increases the tendency to leak.
Patients who have suffered aortic dissection are at risk of Aortic aneurysm formation at the site of the dissection, thought to be due to weakening of the aortic wall. [43] The risk of this aneurysm degeneration is 10 times higher in individuals who have uncontrolled hypertension, compared to individuals with a systolic pressure below 130 mmHg.
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