Mr. Quynh was diagnosed with aortic valve stenosis three years ago. Initially, his symptoms were not severe, and he maintained normal daily activities, experiencing only mild dizziness when changing positions from sitting to standing, and occasional fleeting chest pains. However, over the past three months, he developed shortness of breath during exertion and chest pain behind his breastbone, which prevented him from engaging in heavy labor. Consequently, he sought examination at Tam Anh General Hospital, TP HCM.

Professor Doctor Vo Thanh Nhan, Director of the Interventional Cardiology Center, diagnosed the patient with severe aortic valve stenosis. This condition occurs when the valve does not open fully, obstructing blood flow from the heart into the systemic circulation, leading to reduced cardiac output and decreased blood supply to organs. The disease progresses silently over a long period, eventually causing stage 3 heart failure. If left untreated, heart failure would advance to its final stage, increasing the risk of arrhythmias, endocarditis, and sudden death. According to Professor Nhan, the prognosis for survival beyond two years at this stage is only 50% without intervention.

Given the patient's numerous underlying conditions, including hypertension, heart failure, moderate aortic regurgitation, ischemic heart disease, and dyslipidemia, traditional open-heart surgery posed significant risks. The medical team opted for transcatheter aortic valve implantation (TAVI), a minimally invasive procedure that avoids opening the sternum, thereby reducing the risk of complications. The new valve is designed to last up to 12 years.

Doctors performing transcatheter aortic valve implantation for the patient. Photo: Trung Vu

The patient's aorta presented a challenging, tortuous path, complicating the advancement of the catheter from the femoral artery to the aortic valve. Additionally, the aorta was horizontally positioned. Using an older generation of self-expanding valves would have made the procedure difficult. The doctors instead utilized a new generation balloon-expandable valve, featuring a flexible catheter body that easily navigated the winding vessels. After over one hour, the new valve was precisely positioned, effectively taking over the role of circulating blood throughout the body. The patient's heart function improved, and his shortness of breath, fatigue, and chest pain resolved. He was discharged after three days.

Professor Nhan assessed that the new valve is functioning well, and the patient experienced minimal pain, expecting to resume normal activities within 4-6 weeks.

Professor Nhan checking on Mr. Quynh on the second day after the intervention. Photo: Minh Huyen

Professor Nhan stated that SAPIEN 3 represents an advanced generation of balloon-expandable valves. Compared to other TAVI valves, SAPIEN 3 offers high positional accuracy. Its compact size facilitates future coronary interventions or the placement of another valve, providing severely ill patients with an extended opportunity for a healthy life. Transcatheter aortic valve implantation (TAVI) is a complex procedure; imprecise maneuvers can lead to unwanted risks such as bleeding, vascular occlusion, or aortic rupture, which can be fatal. This technique has received approval from health insurance, offering patients access to modern treatment methods at a reasonable cost.

Thu Ha