TAVI and Its Applications for Heart Valve Issues in Taiwan - Cardiology

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Transcatheter Aortic Valve Implantation (TAVI) has revolutionized the treatment of heart valve diseases, particularly for patients who are at high risk for traditional open-heart surgery. In Taiwan, as in many parts of the world, TAVI is primarily used for aortic valve replacement; however, the field is evolving, and there is growing interest in its application for other valves, including the mitral and tricuspid valves.

1. Use of Transcatheter Techniques for Tricuspid Valve Repair or Replacement in Taiwan:
Currently, transcatheter approaches for tricuspid valve interventions are being explored, but they are not as widely established as TAVI for aortic valve replacement. The tricuspid valve is anatomically and functionally different from the aortic valve, which presents unique challenges for transcatheter interventions. While there are devices and techniques under investigation for tricuspid valve repair and replacement, their availability and approval may vary by institution and regulatory status. Some hospitals in Taiwan, including Chimei Medical Center, may be participating in clinical trials or have access to investigational devices aimed at treating tricuspid regurgitation. It is essential to consult with a cardiologist who specializes in structural heart disease to discuss the most current options available and whether your family member qualifies for such procedures.

2. Replacing a Mechanical Mitral Valve with a Bioprosthetic Valve via Transcatheter Techniques:
The replacement of a mechanical mitral valve with a bioprosthetic valve using transcatheter techniques is a complex issue. Currently, there are no widely accepted transcatheter methods for replacing a mechanical mitral valve. The existing transcatheter mitral valve replacement (TMVR) technologies are primarily focused on patients with native mitral valve disease or those with failed bioprosthetic valves. The presence of a mechanical valve complicates the situation due to the need for anticoagulation therapy and the potential for thromboembolic events.
However, advancements in technology may lead to new options in the future. Some centers are exploring innovative techniques, such as valve-in-valve procedures, where a new valve is placed within an existing bioprosthetic valve. This approach is not yet standard for mechanical valves and would require careful consideration of the risks and benefits.

In conclusion, while TAVI is a well-established procedure for aortic valve replacement, the application of transcatheter techniques for tricuspid and mitral valve interventions is still developing. For your family member, it is crucial to have a thorough evaluation by a cardiologist who can provide personalized recommendations based on their specific condition, the severity of the tricuspid regurgitation, and the risks associated with further surgical interventions. They can also discuss the potential for participation in clinical trials that may offer access to cutting-edge therapies.