they do (as far as I know) trim the cusps off and pull them back in along the catheter; then inserting the spring loaded valve into that ring as a bed.
No, I did not know of the Trifecta recall. Thank you very much for that. Mild leakage stared about two years after the OHS and stayed fairly stable for another two years or so. Last May,6 yrs post op, fatigue started again and last month I had an echo which showed advanced deterioration hence the need for a new valve. Pre op is tomorrow and I will know a lot more about what is going to happen and the info on the new valve. My understanding now is that they do not remove the Trifecta but rather insert a new valve inside it. My worry is that as the Trifecta further deteriorates further will it impair the the TAVER. Sounds like there will be a lot more Trifecta replacements in the future.
Will do
So, did the deterioration happened in just the past 6 months? When the fatigue started in May, hopefully they gave you an echo at that time, especially as they knew that you have a Trifecta valve. The instruction from the FDA is for physicians to monitor patients with a Trifecta valve closely for signs of early failure. If they did not give you an echo in May, when was your last echo before the one that you just had recently?
That is correct. With a TAVR or TAVI procedure, the new valve is inserted inside the old valve and expanded. The old valve remains there, basically pushed to the sides by the new valve.
That's not how it works. It really doesn't matter what condition the Trifecta leaflets are (unless abnormally calcified), once a TAVI is deployed (properly) those leaflets are out of the way and should have no further ramifications.
I seem to recall videos where the leaflets are snipped off (where does the calcium deposit go? Into the capture net I suppose) before the TAVI valve is inserted.
I have never seen that but doctors have been known to do things "off label". Usually the restriction is the frame of the bio prothesis unless the leaflets are severely calcified. In such case a TAVI would be contra indicated (not recommended).
Look forward to your report! (and the longer term one in 5 years too)
Well, back home after the TAVR. Was in the hospital appx 48 hrs. The procedure went well and was actually a lot easier , at least on me, than I had anticipated. The whole thing took less than2 hrs. A Medtronic 26mm Evolt Pro was inserted. The least amount of contrast dye was used to do the job as I am also in Stage 4 CKD. Echo performed during the TAVR showed no regurgitation and secure fit was the result.Echo taken this morning confirmed yesterdays procedure. What I don't yet is what the ejection fraction is and also the pressure gradient of the valve. Cardio told me it will take some time for things to stabilize . New appointment in 2 weeks . Although it is early post op, I do feel a lot better. A lot more energy and no pain. Some discomfort in groin area but that is to be expected. Orders are to take it easy and not to overdue things even though I may feel like it. When you think about it, this is really an amazing procedure. Time will tell how this whole this plays out.
sound advice. Follow it.
indeed and I'd say that for their design criteria they are an excellent solution.
