Severance Hospital said Monday it has completed 200 cases of percutaneous transcatheter aortic valve implantations (TAVI) since the first implantation performed in 2011.

A doctor at Severance Hospital performs a percutaneous transcatheter aortic valve implantations (TAVI) procedure at the hospital located in Sinchon, Seoul.

TAVI is a minimally invasive procedure for replacing a cardiac aortic valve that has lost function due to aortic stenosis, or the narrowing of the exit of the left ventricle of the heart. It is a treatment option for inoperable patients with symptomatic severe aortic stenosis, and an alternative to surgery in select, high-risk patients.

Severance said it mainly focused on the elderly patients with moderate to severe symptoms, with the average age of patients being about 81 years. The average age of patients at other hospitals stood at 75 years. The proportion of complex patients with comorbidities such as stage-three chronic kidney disease was also high, the hospital noted.

According to Severance, multidisciplinary care, in which several departments work together to find optimal treatments for each patient, leads to successful procedures for high-risk patients.

"Severance Hospital has accumulated a wealth of experience in treating high-risk patients through many successful TAVI procedures for patients with multiple diseases,” Professor Hong Myeong-ki from the Department of Cardiology said. "We are improving the success rate of treatment of high-risk patients by establishing customized treatment plans for patients through interdisciplinary care, which includes the departments of cardiovascular surgery, cardiopulmonary medicine, and anesthesiology.”

Expertise in contrast-free procedures is also a primary reason the hospital team has been successful with high-risk patients, it said. In many cases, contrast-enhanced injections are inevitable to examine the heart and surrounding blood vessels carefully. However, patients with impaired kidney function may experience unexpected complications and side effects from them.

To reduce this risk, the Severance team has expanded the scope of testing and intervention procedures that do not use contrast agents for chronic renal failure patients.

"Contrast agent injections raise the risk of worsening kidney function. We are therefore expanding the use of CT examinations without contrast agents and minimal-dose TAVIs,” Professor Ko Young-guk said.

The hospital also noted that it only applies the TAVI after careful examination of the patient’s condition and life expectancy for optimal treatment. Severance will expand its clinical studies further to broaden the coverage of TAVI procedures, having achieved 200 cases of the implementations to find the best-individualized treatment for each patient.

yjc@docdocdoc.co.kr

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