Asan Medical Center sets Asian record in aortic valve stenting procedures

Asan Medical Center said Monday that its Heart Institute has performed more than 2,000 cases of transcatheter aortic valve implantation (TAVI), a stenting procedure performed without general anesthesia in older adults with severe aortic stenosis. It is the most among medical institutions in Asia.

Aortic stenosis is an age-related condition where the aortic valve—the gate that pumps blood from the heart's left ventricle to the aorta—becomes calcified, hardened, and narrowed, which impedes blood flow. Once diagnosed, severe aortic stenosis has a 50 percent mortality rate within two years.

In the past, aortic stenosis was treated with open chest surgery. Recently, however, the TAVI procedure, in which an artificial valve is inserted through a blood vessel in the groin or wrist to replace the aortic valve, has become the standard treatment.

Asan Medical Center’s Heart Institute – Chair Professor Park Seung-jung and Professors Park Duk-woo, Ahn Jung-min, and Kang Do-yoon – became the first medical institution in Korea to perform TAVI in 2010 and recently completed its 2,000th TAVI procedure, the most in Asia.

Despite being a high-risk procedure with 2,000 patients’ average age of 80.3 years, they had a 99.7 percent success rate to date. With a significantly lower complication rate of 1.9 percent for severe stroke and 1.4 percent for early mortality (within 30 days), Asan Medical Center’s outcomes are on par with leading hospitals, such as Cedars-Sinai Medical Center and Cleveland Clinic in the U.S., which perform the most TAVI procedures worldwide.

The TAVI procedure involves passing a balloon along an arterial blood vessel in the thigh to the heart valve, inflating the balloon between the narrowed valves, and inserting a mesh-like artificial valve stent to replace the existing valve.

The procedure is considered one of the most challenging cardiovascular interventions due to the high risk of damage to the aorta and blood vessels, potential strokes from dislodged blood clots, and electrocardiogram abnormalities.

At Asan Medical Center’s Heart Institute, cardiologists and cardiovascular and thoracic surgeons conduct a thorough screening of patients through weekly integrated consultations to discuss whether they are candidates for TAVI and determine the size and type of valve through precise analysis of images, including ultrasound and CT, before the procedure. The procedure is performed in a hybrid operating room dedicated to TAVI, equipped with advanced imaging, procedural, and surgical equipment.

To prevent strokes that can occur during TAVI, high-risk patients are given a clot-catching device called the Sentinel to keep clots from breaking off and traveling to the brain vessels during the procedure. According to the hospital, to minimize anesthesia side effects, patients are also given sedation instead of general anesthesia to help them recover safely and quickly.

The number of TAVI procedures at Asan Medical Center has been rising rapidly every year since May 2022, when the procedure began to receive expanded health insurance benefits due to its safety and effectiveness. In 2022 alone, 306 patients received the TAVI procedure at the hospital, and 370 severe aortic stenosis patients did so in 2023.

“Asan Medical Center’s Heart Institute is the first in Asia to achieve the global milestone of 2,000 advanced TAVI procedures. The performance of the procedure is on par with the world's leading hospitals, such as Cedars-Sinai Hospital and Cleveland Clinic in the United States, which perform the most TAVI procedures,” Chair Professor Park Seung-jung said. “That has become possible because of the organic teamwork of the medical staff involved, including the cardiology department, cardiovascular and thoracic surgery department, cardiac laboratory team, and cardiac nursing team.”

Professor Park Duk-woo said, “Based on Asan Medical Center's unrivaled experience in performing the first and largest TAVI procedure in Korea, we will continue to provide safe and healthy treatment for high-risk, older adults with aortic valve disease who are difficult to operate or who want a non-invasive TAVI procedure.”