Bumrungrad International Hospital’s newly opened Heart Valve Center features a team of doctors and multidisciplinary experts ready to provide innovative treatments for heart valve disorders using Transcatheter Aortic Valve Implantation (TAVI) technology. The TAVI procedure involves the implantation of a replacement aortic valve via a tiny chest incision, meaning patients experience minimal pain and recover faster after the procedure.
According to the United Nations World Population Ageing Report, Thailand is one of a number of countries currently undergoing social transformations that will ultimately result in an aged society. The UN report states that any country with more than 10% of its population over the age of 60 is an aging society, while this status can be upgraded to an aged society should the proportion of over-60s increase beyond 20%. Thailand is projected to become an aged society by 2021, when the percentage of over-60s surpasses 20% of the total Thai population.
Dr. Winyou Ratanachai, Chief Medical Officer at Bumrungrad Hospital, commented: “Bumrungrad Hospital recognizes the ongoing transformation occurring in our society requires us to be prepared to offer support for all aspects of geriatric healthcare. This is especially crucial in terms of treating illnesses associated with cardiovascular diseases, which are some of the most common causes of death among our elderly population.
“We therefore employ a team of doctors, medical staff and multidisciplinary experts, equipped with the latest medical technology, to ensure we can offer world-class healthcare. Additionally, our newly opened Heart Valve Center further enhances our comprehensive, multidimensional range of services aimed at disease prevention, early diagnosis, treatment and rehabilitation, all of which are overseen by a highly experienced team of experts committed to ensuring that the highest levels of safety and quality are maintained at all times.”
Statistics from Thailand’s Ministry of Public Health (MoPH) for 2018 reported 432,943 new cardiovascular disease cases in Thailand for the year, and 20,855 deaths during the year caused by the condition. That works out to 48 deaths every day due to cardiovascular disease, or 2 per hour. The large number of people suffering from heart disease has led to crowded emergency rooms throughout the country, underlining the urgent need for the MoPH to find faster, more effective approaches to prevention and treatment in order to reduce the widespread harm being inflicted by cardiovascular disease.
Dr. Visuit Vivekaphirat, Medical Consultant to the Director of Bumrungrad Hospital and an expert in the field of cardiovascular disease, noted: “Heart disease can often be a silent danger due to it frequently progressing with no symptoms or indicators to alert people of the danger. In turn, patients tend to overlook the importance of regular periodic heart health screenings, resulting in many patients with heart disorders not being diagnosed during the early stages, thus raising the risk of heart failure. Annual heart health screening is something we should all be vigilant about in order to protect against serious, potentially life-threatening conditions.
“The heart diseases most common among elderly include coronary artery disease or obstruction, aortic valve stenosis, atrial fibrillation, bradycardia and heart failure. Fortunately, Bumrungrad Hospital now has a number of centers dedicated to treating heart disease, including the Heart Center, the Arrhythmia Center and, most recently, the Heart Valve Center, all of which ensure our patients that they are being cared for by highly experienced medical professionals who possess significant expertise in providing individualized care for cardiovascular disease.”
The Connection between Aging and Heart Valve Disorders: What Signs to Watch For and When to Seek Treatment
If you or someone you know is an older adult who has experienced an episode of tiring easily, fainting and/or feeling tightness in the chest, this may be a sign of a heart valve problem that requires a doctor’s consultation. One of the most common and serious valve disorders, known as aortic stenosis, occurs when an obstruction blocks the valve connecting the heart’s lower left chamber with the aorta. This condition is most common among older adults, and if it is left untreated, there is a good chance it will end up being fatal within 2–5 years.
According to Dr. Wattanaphol Phipathananunth, Director of the Heart Valve Center at Bumrungrad International, in general terms, the right side of the heart is responsible for circulating oxygenated blood through the arteries to enable gaseous exchange to take place in the lungs. After this occurs, the oxygenated blood is transferred back into the left side of the heart, making the lower left chamber the last place through which blood exits the heart and enters the arteries before being circulated around the body.
The aortic valve is therefore comparable to a valve that connects a water faucet to a main pipe. The aortic valve degenerates with age and is prone to obstruction as a result of plaque build-up or general age-related deterioration. Aortic valve disorders pose a risk in men as well as in women, and taking good care of one’s health may not necessarily be enough to avoid aortic valve disorders.
These disorders are among the cardiovascular conditions that tend to go undiagnosed unless the patient undergoes certain types of screenings. However, one symptom that indicates a valve disorder is tiring easily due to heart failure, the term that describes the heart’s inability to pump blood around the body properly. When resulting from a lower left ventricle irregular beating, it could cause a pulmonary edema alongside tightness in the chest and fainting, although it is possible that such symptoms may be caused by problems associated with aortic valve stenosis. For this reason, regular heart screening is an essential aspect of any health check-up, especially in the following groups:
• adults aged 40 and above
• those with co-existing chronic conditions such as diabetes, high cholesterol, high blood pressure and obesity
• smokers
• those with a family history of heart disease
People in these groups should undergo regular periodic health check-ups and examinations, as well as specific screenings related to heart health, such as EKG and echocardiogram screenings.
Well-trained Doctors Lead Multidisciplinary Team at Bumrungrad’s Heart Valve Center
Bumrungrad International Hospital has put together and developed a team of highly experienced medical staff with expertise in the field of cardiology in order to establish its new Heart Valve Center. The center provides a comprehensive range of healthcare services, including preventive care, diagnosis, treatment and cardiovascular rehabilitation. The medical team consists of general cardiologists, interventional cardiologists, echocardiogram specialists, anesthesiologists with specialized training in cardiology, and a nursing team with extensive experience in cardiology.
They are supported by the center’s well-equipped facilities, with advanced cardiac imaging technologies, a dedicated cardiac intensive care unit (CCU) and extensive cardiac rehabilitation facilities. All doctors and medical staff at Bumrungrad have attended training programs and seminars related to the aforementioned procedures in countries including the U.S. and Australia, ensuring they remain up-to-date with relevant knowledge and training required to provide patients and their relatives with insight and in-depth analysis of medical issues and treatments. Patients can be confident that the medical equipment utilized for treatment at Bumrungrad has been carefully selected and meets the hospital’s stringent international safety standards.
Treating Aortic Valve Stenosis
Currently, treatment for aortic valve stenosis consists of 3 main techniques:
1. Medications that treat specific symptoms of the disorder.
2. Aortic Valve Surgery: The conventional form of treatment for aortic stenosis involves open-heart surgery to remove the existing aortic valve and replace it with an artificial valve.
3. Transcatheter Aortic Valve Implantation (TAVI) surgery: This new minimally invasive surgical procedure for aortic valve stenosis involves implantation of a replacement valve inserted through the femoral artery in the groin, or via a tiny puncture made in the apex of the heart. Once the tube carrying the replacement valve reaches the target site, surgeons will release the compressed valve into the delivery system, where it pushes aside the leaflets of the damaged valve, and the existing valve helps holds the new valve securely in place.
Dr. Wattanaphol expanded on this, adding: “Although open heart surgery is the conventional treatment and still very effective in treating aortic valve stenosis, not all patients with the disorder will be suitable candidates for the conventional surgery. This is due to the complex demands of the surgery: patients must be anesthetized throughout; the procedure involves the use of respirators; and the 4-hour duration of the surgery is something some patients won’t be physically able to tolerate. This is a particular concern for older patients, those who have previously had open-heart surgery, and people with other chronic conditions. If the doctor considers open-heart surgery to be too much of a risk, they may instead recommend undergoing a TAVI procedure to minimize the risk of complications.”
The TAVI Technique: Minimally Invasive Valve Replacement Surgery
Dr. Wattanaphol concluded by noting: “The TAVI technique is a new type of surgery that should only be performed under the care and supervision of expert medical staff in fully prepared hospital facilities. The TAVI technique is best suited to patients with severe aortic stenosis who would be considered “high risk” were they to undergo conventional open-heart surgery. The high risk group includes those with chronic conditions; those with lung disease; people who have previously undergone open-heart surgery; and patients over the age of 80.
Patients considered most at risk are those with level 3 stenosis, because this means the valve is allowing hardly any circulation — like a faucet that is barely open — and blood cannot be pumped around the body with any efficiency. The process of replacing the damaged valve with an artificial valve involves the insertion of a catheter through the femoral artery in the groin. The procedure takes just over an hour to complete, which is much less time than open-heart valve replacement surgery (around 4 hours). The minimally invasive nature of the technique leaves patients with only a tiny wound at the incision site, resulting in less pain and quicker rehabilitation times. Patients require a hospital stay of around 5–7 days before returning home, whereas this period can be as long as 2–3 months for open-heart surgery. From monitoring previous recipients of the TAVI technique, the surgery has been found to be highly effective, with patients experiencing no negative side effects, while enjoying improvements in their overall quality of life.”
Bumrungrad’s strong commitment to world-class standards of care reflects the importance of patient safety hospital-wide. This commitment extend through every step of the patient experience, from the diagnosis stage, to consultations with patients and their families both before and after treatment, through the close monitoring and after-care following the conclusion of treatment. This ensures that every patient enjoys the kind of quality care and safety they deserve.
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21/11/2019