Cardiovascular medical advancements in Taiwan

Medical professionals in Taiwan are highlighting advanced surgical and minimally invasive options for treating complex cardiovascular conditions. Experts emphasize that for high-risk patients with coronary artery disease, such as those with diabetes, coronary artery bypass surgery (CABG) may offer better long-term survival rates than stents.

To address the needs of an aging population, medical institutions are shifting toward a ‘lifetime management’ approach for heart valve diseases. This includes utilizing multidisciplinary ‘Heart Teams’ to facilitate integrated care and long-term planning for the eventual wear of artificial valves. Technological advancements such as Transcatheter Mitral Valve-in-Valve (TMViV) and Transcatheter Aortic Valve Implantation (TAVI) are being used to provide minimally invasive alternatives to traditional open-chest surgery.

Recent developments at institutions like Linkou Chang Gung Hospital demonstrate the efficacy of staged, multi-organ treatment strategies. For instance, an 85-year-old patient with both aortic stenosis and lung cancer was treated by first undergoing TAVI to stabilize cardiac function, followed by minimally invasive thoracoscopic surgery to address the malignancy.

Further technical refinements include the use of ‘dry valves’ in TAVR procedures to improve durability and reduce calcification. Additionally, the National Health Insurance Administration has expanded access by including certain transcatheter valve-in-valve procedures under conditional coverage for high-risk patients, helping to mitigate the financial burden on elderly citizens.