'TAVI' Procedure Growing Hope for Patients with Aortic Valve Stenosis

Professors Seungjeong Park, Deokwoo Park, and Jungmin Ahn from the Department of Cardiology at Asan Medical Center in Seoul are performing TAVI procedure on a patient in their 80s.
[Photo by Asan Medical Center]

[Asia Economy Reporter Lee Gwan-ju] For patients with aortic valve stenosis, 'Transcatheter Aortic Valve Implantation (TAVI, Tavi),' which replaces the aortic valve by inserting an artificial valve through a minimal incision instead of open-chest surgery that involves cutting open the chest, has become the standard treatment. Although it is considered one of the most challenging cardiovascular interventional procedures, it has advantages such as shorter procedure time, less patient pain, and reduced hospital stay. Seoul Asan Medical Center, which first performed TAVI in Korea in 2010, exceeded 300 cases last year alone.

Valve Insertion Without Open-Chest Surgery... Better Patient Prognosis

The valve assists the heart in pumping blood throughout the body to supply cells with oxygen and nutrients. However, valves wear out with aging. In fact, valve disease is common, affecting 3-4% of elderly people aged 75 and older. Aortic valve stenosis occurs when the aged aortic valve narrows, causing blood flow obstruction. Symptoms such as chest pain and shortness of breath occur, and there is a high risk of sudden death.

TAVI is a cutting-edge treatment that allows insertion of a valve without opening the chest for elderly or high-risk patients with severe aortic valve stenosis. Through the femoral artery, the artificial valve stent is delivered to the heart valve and fixed between the narrowed valve leaflets to replace the existing valve. Compared to open-chest surgery, patient prognosis is better, but the procedure is equally difficult. The hospital’s system and the proficiency of its staff must be well established to safely conduct the entire process from examination and diagnosis to procedure and recovery for aortic valve patients.

In Korea, Professor Park Seung-jung of the Department of Cardiology at Seoul Asan Medical Center first performed the procedure in March 2010. Since then, Seoul Asan Medical Center achieved 1,000 TAVI cases in May 2021, the first in Asia, and has performed a total of 1,458 cases up to last year. Notably, 303 procedures were successfully performed last year alone, surpassing 300 cases for the first time in Korea. This is considered one of the highest levels in the Asia-Pacific region and is comparable to the top 10 large hospitals in the United States that perform the most TAVI procedures. According to Seoul Asan Medical Center, the average hospital stay for TAVI patients is about 4 days, and despite the average patient age being around 80 years old in this high-risk group, the procedure success rate has been 99% over the past five years.

Expanded Insurance Coverage for Elderly and High-Risk Groups... Reduced Burden

TAVI procedures are expected to become more active in Korea going forward. Since May last year, insurance coverage has expanded after safety and efficacy were recognized. The patient co-payment rate for elderly and high-risk groups dropped from 80% to 5%. Medium-risk groups pay 50%, and low-risk groups pay 80%. The expansion of insurance coverage has actually led to an increase in procedures among elderly patients. Before the insurance expansion, the average age of TAVI patients at Seoul Asan Medical Center was 79.3 years, but it rose to 80.6 years shortly after. The oldest patient who underwent the procedure last year was 96 years old.

Professor Park Deok-woo of the Department of Cardiology at Seoul Asan Medical Center said, "To perform 300 TAVI procedures annually, a systematic system that allows all processes?from examination and diagnosis to procedure and recovery?to flow smoothly is essential. Based on the unparalleled experience accumulated as the first and largest TAVI center in Korea, we will continue to do our best to be the last hope for elderly patients with severe aortic valve stenosis who are difficult to operate on or who desire minimally invasive TAVI procedures."

This content was produced with the assistance of AI translation services.