The advent of Resilia tissue, which is an advanced TAVI valve, allows for dry storage and prolongs valve deterioration, which, in turn, could mean that the valve will last much longer. At present, there are four TAVI valves, approved by DCGI, being used for patients. There are three to four more companies that are making new valves. Once these valves are approved, the price and affordability of this therapy are definitely going to come down.
Dr. Ravinder Singh Rao, Interventional Structural Cardiologist, , Lilavati Hospital and Research Centre, Mumbai, to figure out the latest advancements in TAVI and how AI is impacting the procedure, besides the buzz around affordability with more TAVI valves being made in India.
TAVI: Advancements
TAVI was done for the first time in 2002. Since then, TAVI has come a long way Back in 2012, we were doing TAVI only for patients who were not fit for open heart surgery. But now we have evidence that TAVI even better than surgery, even for inpatients who are at low risk for surgery. At present, anybody above the age of 65 can replace the aortic valve or do the Tavi from the femoral artery; it has become a treatment of choice. The advancement that has actually happened is in the durability data of the TAVI valve. Earlier, they were wondering whether this value would last longer or not. Now, we have data from almost 10 to 12 years, comparing TAVI with surgery, showing this valve is going to last as long as a surgically implanted tissue valve. The complications like paravalvular leakage, the pacemaker rate, bleeding, and the requirement of surgery have drastically gone down, with AI, or artificial intelligence, coming up in a big way.
AI impacting TAVI
The way AI is going to help us with TAVI patients is that, with AI, we can predict what can go wrong on the table. The way it is done is that even before doing the TAVI procedure, we will be doing a CT angiography, and AI is going to help us implant the valve hypothetically on the software and help us understand the interaction of the of the valves, even before we go for the procedure. So, we would know that these are certain things about which we have to be careful when we do the procedure. So, it’s like we would do the procedure on the computer with an AI and then replicate or implement it in the Cath lab.
- TAVI: Make in India
TAVI, which we make in India, has come a long way. I did the very first case of using the India-made valve in 2017. Now that we have seven years of follow-up, we know that the TAVI valve made in India is good. We also presented this data at London Valves, which is one of the largest valve meetings, and showed that this valve is safe and effective. I was the principal investigator of this study as well. Now that TAVI is made in India, proving its durability, safety, effectiveness, and definitely affordability, more and more patients can benefit from it.At present, there are four TAVI valves that are approved by DCGI, which is the Government of India, and are being used for patients. There are three to four more companies that are making new valves. Once more and more valves are manufactured and we show their safety, effectiveness, and durability, the prices and affordability of this therapy are definitely going to come down.
