 I'm Dr. Ranjan Shetty, I head Cardiology at Manipal Hospital, Bangalore. So I'm here to talk about TAVI or Trans-Catheter Iotic Val. Iotic valve stenosis is again very common condition. At age of 61 to 2 percent have some changes in Iotic Val by age of 80. In elderly, the Iotic valve stenosis percentage increases to 2 to 5 percent. These people present with problems when they walk, there are exertional symptoms, they could get exertional chest pain, they could get fatigue. So any elderly who has difficulty in walking, who becomes breathless while walking, who has some murmur which is picked up on routine examination, needs to undergo an echocardiogram and we need to evaluate whether there are problems in Iotic valve. The stenosis of Iotic valve is called Iotic Stenosis and this is like a dam, it does not allow blood to go forward, the blood goes backward, people feel fatigue, tired and breathless, they could even get chest pain while walking. Many elderly think that it is age related and do not get them evaluated, so if there are any such symptoms, it's important to see a doctor, a doctor can easily pick up a murmur which is easily audible with stethoscope and the echocardiogram confirms the diagnosis. Earlier, the most common treatment which was done for these people is an open heart surgery where Iotic valve was changed or replaced but now even lowest individual who are above 60 or 65 years of age have an alternative option, that option is called TAVI or Trans-Catheter Iotic Val. Here the procedure is done like angeogram, the catheter is passed through the femoral artery or the groin artery, there are no cuts, there are no stitches, there is no general anesthesia, the catheter is passed and the old valve is crushed and the new valve is implanted. The procedure is almost like angioplasty, takes 30 to 45 minutes, most of the time people are mobile as soon as the procedure is done and by 1 or 2 days they are discharged from hospital. This therapy actually has revolutionized the treatment for Iotic valve stenosis and it is now FDA approved both for low risk as well as high risk individual. So anybody with symptom of exertional chest pain especially elderly, it's important they completely evaluate themselves and not assume that it is an age related decrease in activity and if it is Iotic stenosis they could consider option of Trans-Catheter Iotic Val implantation. There are many heart diseases which are present and there are many many people now who tend to suffer with lot of heart disease, we are here to tell that there are some minimal practically minimally invasive options, these are more minimal than the surgical minimal, these are just you know a single puncture which is put in the groin or a hand. So we are able to do many procedures which were earlier done by open heart surgery which was earlier done by surgeons, the procedures which we are able to do now are valve replacement for Iotic valve called as TAVI, extensively done now available in most centers now. Another clip which is done for mitral valve, left atrial appendage closure which is now done for as alternative to anti-coagulation to AF, along with this there are other minimally invasive procedures which can be done which includes ballooning of mitral valve, Iotic valve or tricuspid valve, it also includes series of angioplasty and day by day even very complex angioplasty are also being done in a very minimally invasive way.