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Percutaneous aortic valve replacement- a revolution in Cardiac Surgery

The aortic valve in the heart is the valve that governs the flow of blood into a large blood vessel namely the aorta, which supplies blood to various organs of the body. // It prevents the blood from flowing back inside the heart from the rest of the body.

The effective functioning of the heart depends on the proper functioning of the aortic valve. The aortic valve can be defective in some cases, leading to a compromise in the same. The defect can be present right form birth or it can be acquired as a result of other diseases.

This cardiac defect can be corrected by a surgical technique called aortic valve replacement that greatly increases the life expectancy of the patients. Nearly 200,000 patients undergo surgical valve replacement worldwide every year. However not all patients can undergo the surgery.

Approximately 2/3 rd of the patients do not receive the surgery due to associated risk factors and morbidity or patient refusal due to fear of lifestyle changes following surgery in elderly patients. The number is only expected to rise, considering the density of aging population.

Thanks to the promise offered by a new, less invasive, therapeutic surgical technique called percutaneous aortic valve replacement that is becoming a reality. The surgical procedure has given hope for a number of patients who cannot currently be treated with traditional surgical techniques.

The surgery has been performed successfully in a cardiac care centre in Canada either under local anaesthesia or under light sedation. Reports regarding the valve performance have been excellent and there has not been a single case of valve failure when the valve was successfully placed (80% of the cases). High mortality during follow-up has been related to non-valvular causes, mainly the evolution of life-threatening comorbidities.

Two multicentre studies have just begun enrollment in Europe (REVIVE trial) and the US (REVIVAL trial ) that will help to determine the future of this revolutionary and promising interventional cardiology procedure. If technical hurdles regarding the surgical procedure are overcome, then the option could be made more feasible in high-risk cardiac patients.

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