Diane Farrow

For about a year I put it down to age. I was breathless on the stairs, I had to stop halfway up the hill to the shops, and once, in the garden, the world went grey at the edges and I had to sit down on the wet grass. The word, when it finally came, was aortic stenosis: the main valve out of my heart had stiffened and narrowed until it was barely opening. Left alone, the cardiologist said gently, this was the sort of thing that shortened lives.

What I expected next was open-heart surgery, the sternum sawn open, weeks in hospital. What I was offered instead sounded like something out of a magazine: a new valve, folded up small, threaded on a wire up through the artery in my groin and opened inside the old one while my heart kept beating. Two nights in hospital. That procedure is called TAVR, and I later learned it is one of the largest shifts in heart medicine in fifty years. At the time, all I could find to read about it was either a leaflet that told me nothing or a journal paper I could not follow.

So I wrote the thing in between. Biomedical Advances is my attempt to explain, in plain language, what a failing heart valve does to you, how these keyhole procedures actually work, and what the recovery, the risks, the durability and the cost are genuinely like. I am not a doctor. Dr. Helena Voss, a consultant cardiologist, checks everything clinical so the facts are sound. The part about being wheeled in wide awake and out again two days later is mine.