MRI safety of TAVR or TAVI Valves

Transcatheter Aortic Valve Implantation (TAVI) is a minimally invasive procedure used to replace a diseased aortic valve with a prosthetic valve. Magnetic Resonance Imaging (MRI) is a diagnostic imaging technique that uses a strong magnetic field and radio waves to generate detailed images of the body's internal structures. When considering the safety of TAVI in relation to MRI, there are a few important points to consider:

1. MRI Compatibility of TAVI Devices: The prosthetic valves used in TAVI procedures are typically made of metal and may contain components that can be affected by the strong magnetic field of an MRI machine. In the past, many TAVI devices were considered contraindicated for MRI due to potential risks such as valve displacement or heating. However, newer generations of TAVI devices have been developed with improved MRI compatibility.

You can check the MRI compatibility of your valve or device at : http://www.mrisafety.com/TMDL_list.php

2. MRI Conditional TAVI Devices: Some TAVI devices are specifically designed and labeled as "MRI conditional." This means that they have been tested and determined to be safe for use in patients undergoing MRI under certain conditions. The manufacturer's instructions for use (IFU) provide specific information regarding the MRI conditions that can be safely followed, such as the maximum magnetic field strength, specific absorption rate (SAR) limits, and scanning sequences.

3. Precautions and Assessments: Before undergoing an MRI, it is essential to assess the specific TAVI device implanted and its compatibility with MRI. This assessment is typically performed by the treating physician or a radiologist. They will review the patient's medical history, including the details of the TAVI procedure and the implanted device, and consult the device manufacturer's guidelines to determine if an MRI can be safely performed.

4. Monitoring and Follow-up: In some cases, additional monitoring may be required during an MRI scan for patients with TAVI devices. This may involve continuous monitoring of vital signs and electrocardiography (ECG) to ensure the patient's safety throughout the procedure. The medical team will closely observe the patient for any signs of discomfort, abnormal valve function, or complications during and after the MRI.

It's important to note that the specific safety guidelines and recommendations can vary depending on the TAVI device used and its MRI compatibility. Therefore, it is crucial for patients and healthcare professionals to consult the device manufacturer's instructions and work together to make informed decisions regarding MRI safety for individuals with TAVI implants.

TAVR Valve durability or Lifespan of TAVI Valve

The durability of TAVR (Transcatheter Aortic Valve Replacement) valves is an important consideration when deciding on treatment options for patients with aortic stenosis. While TAVR has been shown to be a safe and effective alternative to open-heart surgery for many patients, the long-term durability of the TAVR valve is still being studied.

Several studies have reported on the durability of TAVR valves over time, with results suggesting that TAVR valves may have similar or better durability compared to surgical valves in selected patients. For example, a study published in the New England Journal of Medicine in 2021 reported that among patients at intermediate surgical risk, the rate of structural valve deterioration at 5 years was similar between TAVR and SAVR (Surgical Aortic Valve Replacement) patients. Another study published in the Journal of the American College of Cardiology in 2020 reported that among high-risk patients, TAVR valves had similar or better durability compared to surgical valves up to 5 years.

However, it is important to note that the long-term durability of TAVR valves is still being studied and longer-term data are needed to fully understand the durability of these valves. Additionally, the durability of TAVR valves may vary depending on factors such as the patient's age, comorbidities, and the type of valve used.

In summary, while the long-term durability of TAVR valves is still being studied, current evidence suggests that TAVR valves may have similar or better durability compared to surgical valves in selected patients, particularly among those at high risk for surgery. Patients should discuss the potential benefits and risks of TAVR with their doctors to determine if it is the best treatment option for their individual case.

In real world experience, Edwards sapien and Medtronic Corevalve are being in use for long time since the time of TAVI evolution (>20 years) and good number of people have had functioning valve beyond 10-12 years - more so with balloon expandable valve.

TAVI (TAVR) price and its cost-effectiveness in India

TAVR (Transcatheter Aortic Valve Replacement) and SAVR (Surgical Aortic Valve Replacement) are two procedures used to treat aortic valve stenosis, a condition in which the valve that controls blood flow from the heart to the rest of the body becomes narrowed, reducing blood flow and causing symptoms such as shortness of breath, chest pain, and fatigue.

TAVR is a minimally invasive procedure in which a new valve is implanted through a catheter, typically through the femoral artery in the groin, and guided to the heart using imaging techniques. SAVR, on the other hand, is an open-heart surgery in which the damaged valve is removed and replaced with a new valve through an incision in the chest.

There are several differences between TAVR and SAVR. One of the most significant differences is that TAVR is a minimally invasive procedure that does not require opening the chest, while SAVR is an open-heart surgery. As a result, TAVR typically has a shorter recovery time and a lower risk of complications than SAVR.

SAVR may be preferred for younger and more active patients, who may benefit from the longer life span of the mechanical replacement valve. Tissue Valves have similar durability. SAVR is the only option for redo procedures if previous valve is mechanical prosthetic valve.

Ultimately, the choice between TAVR and SAVR depends on the individual patient's health status, age, and medical history, as well as the specific characteristics of their valve disease. Patients should consult with their doctors to determine the best treatment option for them.

Transcatheter Aortic Valve Implantation (TAVI) is a minimally invasive procedure used to treat aortic stenosis in patients who are not suitable for open-heart surgery. The cost of TAVI in India varies depending on the hospital and the type of valve used. Generally, the cost of the procedure ranges from INR 17 lakh to INR 30 lakh.

In terms of cost-benefit, TAVI can be a more cost-effective option compared to open-heart surgery, especially for elderly patients who may have other medical conditions that make them high-risk for surgery. TAVI is a shorter and less invasive procedure, which means that patients usually have a shorter hospital stay and a faster recovery time. This can translate into lower healthcare costs and a quicker return to normal activities, which can be especially important for elderly patients.

However, it is important to note that the cost-benefit of TAVI needs to be evaluated on a case-by-case basis, taking into account the patient's age, overall health, and other medical conditions. Additionally, not all hospitals in India offer TAVI, and the availability of the procedure may also vary depending on the location. Patients should consult with their doctors to determine if TAVI is the best treatment option for them and to discuss the potential costs and benefits.