With TAVI, the Future of Heart Surgery is Here: Dr. Cesar Yepes Explains


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For cardiologist Dr. Cesar Yepes, the future of heart surgery is now. Transcatheter aortic valve implantation, otherwise known as TAVI, is a revolutionary new procedure that is offered to individuals who are not good candidates for open heart surgery or are considered to be high-risk patients. With specialties in interventional and non-invasive cardiology, including transthoracic and trans esophageal echocardiography and nuclear cardiology, Dr. Yepes has shared his expert perspective on why this new procedure should be embraced.

Though still fairly new to the medical field, TAVI is a great option for candidates with aortic estenosis, according to Dr. Yepes. These patients tend to be older, between the ages of 70 and 80, when traditional open heart procedures are deemed to be too risky. The American Heart Association notes that while the procedure can be expensive, obtaining financial assistance is possible, as the procedure is available for those who are on Medicare and Medicaid.

TAVI is a minimally invasive surgery that helps to repair the aortic valve without having to remove the old, damaged valve. According to The American Heart Association, the procedure is similar to when a stent is placed in an artery. Thus, TAVI is capable of providing a fully collapsible replacement valve to the valve site through the use of a catheter.

Once the new valve has been put in place and has expanded, the old valve leaflets are pushed out of the way and the tissue in the replacement valve takes over the job of regulating the blood flow, explains the AMA.

There are many reasons why longtime medical professionals like Dr. Cesar Yepes support this procedure. First and most importantly, he says, “There are fewer complications, less chances of problems occurring, and more opportunities for a successful surgery to take place.”

This is because the procedure is able to take place without opening the chest up, such as in a traditional open heart surgery, which results in a less invasive procedure. Replacing the aortic valve without opening the chest is done by inserting the catheter one of two ways: through the femoral artery in the groin or through a small incision in the chest over the heart.

This type of procedure also results in a shorter healing time. Typically, the healing time for a traditional open heart surgery takes between 6 to 8 weeks. With TAVI, this recovery period is now as short as 2 to 4 weeks.

“We just see fewer complications, risk scores decrease, and it’s all around a safer surgery,” says Dr. Yepes. “The real technological advancements come with the repositional and resheathable valves. The fact that the valves can be repositioned within 2 to 3 seconds is an amazing advancement that cannot be ignored.”

There are risks, he continues, just as there are with any other procedure. However, as technology continues to advance, so does the medical field.

As Dr. Yepes explains, “Leakage is always a concern, but with the upgraded valves, there is less of a chance that problems like this will occur, and most definitely there will be less leakage with the valves being able to be repositioned.”

With any surgical procedure or form of medical care, it is vital that the patient makes an informed decision regarding treatment. Dr. Cesar Yepes supports transcatheter aortic valve implantation and encourages anyone who is suffering from aortic stenosis, and is not currently a candidate for traditional open heart surgery, to speak with a medical professional to find out more information.