Modern technique for Aortic Stenosis treatment will be incorporated into SUS

in SBC

It is estimated that 5% of the world population over 75 years old are carriers of the disease. With longevity, the impact of aortic stenosis on Brazilians health has become of great importance.

The Ministry of Health has announced the incorporation of a new technique for TAVI anytime soon. It will be destined to treat aortic stenosis, a disease that causes the progressive narrowing of the outflow of blood pumped by the heart to the entire body.

The Minister of Health, Marcelo Queiroga, declared that the ordinance has already been approved and will come into effect within 180 days after being published in the Official Diary of the Union, which should happen in the coming days. The procedure will be available at the main referral centers. With advancing age, the aortic valve can become thickened and calcified, causing a reduction in its mobility and making it difficult to eject and circulate blood.

Aortic stenosis evolves with age. It is estimated that 5% of the world population over 75 years old have this disease. As longevity becomes a reality nowadays, the impact of aortic stenosis on Brazilians health has become of great importance. In 2019, we had more than 30 million elderly people over 75 years old, which indicates more than 1.5 million people with the disease in the country today. By 2050, it is expected that this number exceeds 90 million, according to IBGE.

“We are witnessing the evolution of a heart disease still unknown to most people, but which in the coming decades will be as popular as a heart attack”, explains the scientific director of the Brazilian Society of Cardiology, Paulo Caramori. Little was said about aortic stenosis 20 or 30 years ago. “What happens is that people died from cardiovascular disease earlier than today, so they did not have time to live and see the development of the disease,” he says.

After the first symptoms appear, mortality in two years can reach 50%. The main symptoms include shortness of breath and chest pain. Less commonly, arrhythmia attacks or fainting may also occur.

There are no drug treatments for aortic stenosis. Controlling the main cardiovascular risk factors can delay the onset of the disease, although there is still no solid evidence on this.

Risky surgery

About 10 years ago, the only way to save a patient’s life from aortic stenosis was through extensive, long and very risky surgery, especially when dealing with predominantly elderly patients. It was necessary to open one’s chest and extract the totally calcified and clogged aortic valve.

Then, it was replaced with a new valve so the circulation could be restored. In addition to the high rates of complications and intercurrences, the recovery of these patients used to take several weeks to fully happen — and some of them did not survive. That’s the reason why since then the surgery has been worrying cardiologists around the world and pushed them into researching a safer and simpler way to solve the problem. “Depending on the fragility of the case, surgery is not recommended, which leaves the patient without any alternative that could help in their survival”, explains Caramori.

TAVI creates more positive scenario

TAVI performs in a simpler and more effective way the same procedure that was previously achieved only with surgery. With greater safety and higher success rates than the conventional surgical technique, the procedure is now available in several reference centers in the country and the cost is covered by health plans.

The Brazilian Society of Cardiology (SBC) had been in dialogue with the Ministry of Health so that TAV was incorporated by the SUS. “The advantages are very favorable. The reduction in hospitalization costs compensates for the investment in technology. We were finally heard”, highlights Caramori. Most of the time, recovery is very simple: the patient spends only a few hours under observation after the procedure and on the same day (or no later than the next day), they’re already at home.

Recovery is immediate. After replacing the clogged valve, the area quickly returns to normal circulation. “This is another big step towards even greater longevity. If a good part of Brazilians who would reach the average life expectancy in the country would die of Aortic Stenosis, these same patients can now live another 10, 20 years. It’s a huge breakthrough”, concludes.

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