TAVR / TAVITranscatheter Aortic Valve Replacement · Zero Sternotomy Protocol

Severe Aortic Stenosis is an anatomical choke point on the left ventricle. As the valve calcifies and narrows to the diameter of a pencil, the heart muscle must generate crushing pressures to force blood out to the brain and vital organs. Left untreated, severe symptomatic aortic stenosis carries a 50% mortality rate within two years, a prognosis worse than many aggressive malignancies.

For decades, the only clinical recourse was median sternotomy: sawing through the breastbone, arresting the heart on a cardiopulmonary bypass machine, and surgically excising the valve. For frail seniors, octogenarians, or patients with compromised renal or pulmonary function, open surgery was often deemed too dangerous, leaving them without viable options.

Dr. Manish Aggarwal has spent his career dismantling that barrier. Drawing upon his advanced Structural Heart Fellowship at the renowned Gottsegen György Hungarian Institute of Cardiology in Budapest, Dr. Aggarwal performs Transcatheter Aortic Valve Replacement (TAVR / TAVI), deploying a biological heart valve inside the beating heart through a microscopic femoral puncture no larger than a pencil tip.

TAVR is not merely an alternative to surgery; in expert hands, it is an engineering masterpiece of millimetric precision. Success begins long before the patient enters the hybrid catheterization suite at Yashoda Medicity, Indirapuram.

Every candidate undergoes high-resolution electrocardiogram-gated multi-slice CT angiography. Dr. Aggarwal personally reconstructs the aortic root in three dimensions, mapping the annular perimeter, coronary artery take-off heights, calcification distribution, and peripheral vascular access paths with sub-millimeter precision. This rigorous preoperative planning eliminates guesswork and tailors valve selection, whether balloon-expandable or self-expanding, to the patient's exact anatomical geometry.

Tens of thousands of patients who underwent open-heart surgical tissue valve replacements 10 to 15 years ago are now facing structural valve degeneration. Subjecting an elderly patient to a repeat sternotomy carries prohibitive surgical morbidity and mortality.

Dr. Aggarwal is one of Delhi NCR's recognized specialists in Valve-in-Valve (ViV) transcatheter procedures. By navigating inside the failed surgical ring and expanding a modern transcatheter valve within the existing frame, the failing valve is renewed in under an hour without a single surgical scalpel incision. Patients typically walk the following morning.