Tissue valve better option in valvular heart disease says Expert

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NewZNew (Jalandhar) : As many as 80 doctors attended a Continue Medical Education (CME) program on ‘Bioprosthetic (Tissue) valve- a new paradigm in valvular heart disease’ at Hotel Radisson, Jalandhar last night. The CME was conducted by Max Super Specaility Hospital (MSSH), Mohali in association with Physicians Forum Jalandhar.

Among others, Mr. Sandeep Dogra, VP-Operations, Dr. Virendar Sarwal, Director and Head, Department of Cardio Thoracic and Vascular Surgery , MSSH and Dr Alok G Lalwani, President Physicians Forum were presented during occasion. .

Addressing doctors, Dr Sarwal said that valvular heart disease formed a major chunk of heart patients in India. It was mainly rheumatic in origin which affected valves. But as the life expectancy was growing , we were seeing a major chunk of  patient coming with degenerative valvular heart disease also which was most prevalent in western world.

He said, in India, most of the patient of valvular heart disease would require valve replacements with only few were suitable for repairs. A decade ago, only choice available with heart surgeons was mechanical valves or metallic valve. Bioprosthetic valve or tissue valve came in early 70’s but they were first generation valves and their durability was an issue so they started degenerating earlier and fell into disrepute.”

Talking about the choice of valves, Dr Sarwal said that two types of valves, mechanical and tissue or bioprosthetics were available to surgeons. Mechanical valve were lifelong valves which was made up of pyrolitic carbon and titanium ring but would still need anticoagulants or blood thinners to avoid clot formation on the valves. Bioprosthetics valve were made of animal tissue, pig or bovine pericardium, treated strengthened & fixed with chemicals. Though we would call mechanical valve a lifelong valve, anticoagulation has its own problems of bleeding or thrombosis or clot formation, he remarked.

“The new generation tissue valves have good durability of about 16-18 years. The risk of re-operation was much lower than the risk of bleeding or thrombosis. American Heart Association and similarly European Society of Cardiology have recommend tissue valve to any patient aged 65 yrs or more in normal sinus rhythm. However in India, we would take this age to 55 years due to lower life expectancy than the western countries. So in India, we would recommend tissue valve to anybody above 55 years.”

Tissue valve has better performance with no risk of bleeding complication. Keeping in mind the growing population of elderly in Asia now , we would need to give these patients a quality life. The technique of implantation was almost the same except a few modifications. The post-operative care was easier and at home it was much simpler as no blood thinner was required. They could be monitored very closely unlike mechanical valve which would fail suddenly and  carry higher risk, asserted Dr Sarwal.