What is aortic valve replacement and when is it needed?

AVR is a surgical procedure where a diseased aortic valve is replaced. Aortic stenosis (narrowed) or Aortic regurgitation (leaking) are two conditions most commonly requiring a replacement.

Is robotic aortic valve replacement available in India?

Yes, robotic aortic valve replacement is available in India at Apollo Hospital in Bengaluru. It is routinely performed by Dr Sathyaki Nambala but is not available in most hospitals in the country.

Is robotic aortic valve replacement better than TAVI?

Robotic aortic valve replacement is the most advanced surgical technique for replacing the aortic valve. Unlike TAVI, patients with all kinds of anatomy and heavily calcified valves are still suitable for robotic AVR.

What is TAVR/TAVI, and is it available in India?

TAVR and TAVI are two names for the same minimally invasive procedure completed without opening the chest. It is generally indicated for older or sicker patients who are unfit for surgery.

Which valve is better, TAVR or Surgical Valve?

Surgical valves are more durable than TAVI valves. In younger patients, surgical bioprosthetic valves last longer, which has a significant impact on life expectancy. TAVI valves are best suited for patients over 75 who are unfit for surgery.

How safe is robotic aortic valve replacement?

The overall surgical risk is approximately 0.5%. The risk depends on the patient's pre-surgical condition and additional risk factors such as obesity, diabetes, and lung function. The risk of infection is near zero and most patients are fit to go home the next day.

Graft assessment after CABG

Bypass Graft Assessment: TTFM and Epicardial Imaging

How do you make sure a bypass graft is working?

At the end of the operation each bypass graft is checked with probe that measures flow, its called transit time flow measurement or TTFM in short. It basically provides information on the amount of flow, resistance and diastolic flow. Based on these values it's possible to tell the quality of a bypass graft. Imaging will visually demonstrate the flow inside a graft and the bypassed vessel. Together the information gleaned can predict both durability of the bypass graft as well as quality. It significantly decreases the risk of early graft failure as well as a heart attack immediately after the operation.