Our Summary

This research paper discusses issues with heart rhythm (known as conduction disturbances) that can occur after a procedure called transcatheter aortic valve replacement. This is a less invasive procedure used to replace a heart valve that isn’t working properly. The paper states that these rhythm issues can increase the risk of death. Using a CT scan before the procedure can help doctors identify potential risk factors for these rhythm issues. These risk factors include the length of a certain part of the heart (the membranous septum), the amount of calcium in the area where the device will be placed, and the size of the heart valve opening.

FAQs

  1. What is a transcatheter aortic valve replacement?
  2. What potential risk factors for rhythm issues can be identified through a CT scan before the procedure?
  3. How can rhythm issues after a transcatheter aortic valve replacement affect a patient’s health?

Doctor’s Tip

A doctor might tell a patient undergoing aortic valve replacement that it is important to discuss any pre-existing heart rhythm issues with their healthcare provider before the procedure. Additionally, they may advise the patient to follow up closely with their healthcare team post-procedure to monitor for any changes in heart rhythm and to seek medical attention if they experience symptoms such as dizziness, fainting, or palpitations. Regular follow-up appointments and monitoring can help ensure the best possible outcome after aortic valve replacement surgery.

Suitable For

Patients who are typically recommended for aortic valve replacement include those with severe aortic valve stenosis or regurgitation, symptoms such as chest pain, shortness of breath, fainting, or heart failure, and those who have not responded well to other treatments such as medications or lifestyle changes. Additionally, patients who are at high risk for complications during traditional open-heart surgery may also be recommended for a less invasive procedure like transcatheter aortic valve replacement.

Timeline

Before aortic valve replacement:

  1. Patient is diagnosed with aortic valve disease through symptoms such as chest pain, shortness of breath, fatigue, and heart palpitations.
  2. Patient undergoes diagnostic tests such as echocardiogram, electrocardiogram, and cardiac catheterization to determine the severity of the valve disease.
  3. Patient and medical team decide on the best treatment option, which may include medication or aortic valve replacement.
  4. If aortic valve replacement is chosen, patient undergoes pre-operative tests and evaluations to ensure they are a suitable candidate for surgery.

After aortic valve replacement:

  1. Patient undergoes the aortic valve replacement procedure, either through traditional open-heart surgery or minimally invasive techniques such as transcatheter aortic valve replacement.
  2. Patient is monitored closely in the hospital for any complications or side effects from the surgery.
  3. Patient undergoes cardiac rehabilitation to help with recovery and improve heart function.
  4. Patient is advised to make lifestyle changes such as eating a heart-healthy diet, exercising regularly, and quitting smoking to improve overall heart health.
  5. Patient has regular follow-up appointments with their cardiologist to monitor the function of the new valve and address any concerns or complications that may arise.

What to Ask Your Doctor

  1. What is the success rate of transcatheter aortic valve replacement compared to traditional open-heart surgery?
  2. What are the potential complications and risks associated with the procedure?
  3. How long is the recovery process and what limitations should I expect during this time?
  4. Will I need to take any medications after the procedure? If so, what are they and what are the potential side effects?
  5. How often will I need follow-up appointments and monitoring after the procedure?
  6. Are there any lifestyle changes I will need to make after the procedure to improve my overall heart health?
  7. How will the procedure affect my heart rhythm, and what steps will be taken to monitor and manage any conduction disturbances that may arise?
  8. Will I need any additional procedures or interventions in the future to maintain the function of the replacement valve?
  9. How long can I expect the replacement valve to last before needing to be replaced again?
  10. Are there any specific factors in my case that may increase the risk of developing conduction disturbances after the procedure?

Reference

Authors: Nakashima M, Jilaihawi H. Journal: Interv Cardiol Clin. 2021 Oct;10(4):455-463. doi: 10.1016/j.iccl.2021.05.003. PMID: 34593109