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Chula Hospital develops innovative cardiac procedure

KING CHULALONGKORN Memorial Hospital's cardiac centre has developed an innovative, minimally-invasive procedure to treat aortic stenosis without necessitating open-chest surgery.

Transcatheter aortic valve implantation (TAVI) is said to be an option that can reduce surgical complications and allow patients to recover quickly and return to their daily routines.

The centre's head Dr Vichai Benjacholamas said TAVI was proposed by the "Chula TAVI" team at a conference on cardiac structural interventions on June 28 in Frankfurt, Germany, and received international acknowledgement.

However, the process, which is done by inserting a "hydra valve" device into the patient's body, is expensive and is not yet included in any state-run healthcare packages in Thailand, he said.

The hospital's expert cardiologist Suphot Srimahachota said: "The cardiac centre had the opportunity to showcase the TAVI whereby [we are] the world's first to use the hydra cardiac valve, which uses a material produced in Thailand and thus would be cheaper than the imported ones, which is about Bt1 million. But we are still in the process of developing the hydra valve, so the price is yet to be determined."

Patients with aortic stenosis are largely the elderly, because of deterioration of cardiac valves resulting from calcified valve leaflets that caused the valves' opening and closing to be irregular. Global statistics indicate that those over 70 have a 50-to-60-per-cent tendency to have aortic stenosis.

"The current standard treatment is an open-chest operation to change the cardiac valves, but as most patients are elderly people who often have chronic illnesses, the operation poses big risks, and the death rate from surgery is as high as 10-30 per cent," Suphot said.

"At least 30 per cent of patients thus don't get the treatment. The Society of Thoracic Surgeons of Thailand said that in 2008, only nine aortic-stenosis operations were carried out on patients over 80, while 61 operations were done on patients aged 71-80 years. The less invasive TAVI option thus is a possibility to reduce surgical risks and complications."

Since 2010, King Chulalongkorn Memorial Hospital has carried out this TAVI procedure on 31 patients.


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