What is TAVI (Transcatheter Aortic Valve Implantation)?
Transcatheter Aortic Valve Implantation (TAVI) is a minimally invasive procedure for replacing a diseased aortic valve. TAVI involves delivering a new valve via a catheter through the arteries, especially the femoral artery, without open-heart surgery.
Types of Transcatheter Aortic Valve Implantation
The most common approach for TAVI is transfemoral (through the femoral artery in the groin), used in about 80-90% of cases, because it is less invasive and allows for a quick recovery.
Other types based on access include:
- Transfemoral (TF)
- Transcarotid (through the carotid artery in the neck)
- Axillary/Subclavian (through arteries near the shoulder)
- Transapical (through the apex of the heart via the chest)
- Transaortic (directly through the aorta via chest infection)
- Transcaval (from the femoral vein crossing into the aorta)
- Suprasternal-Brachiocephalic (through the upper chest artery)
Each of these types has its own advantages and disadvantages regarding invasiveness, risk of complications, and suitability depending on patient anatomy and condition.
There are mainly two types of valves used in TAVI (Transcatheter Aortic Valve Implantation): Ballon-expandable valves, which are mounted on a balloon catheter and expanded at the site of the native valve to push the diseased valve aside.
Self-expanding valves are made from a self-expanding material like nitinol that expands once deployed to anchor into place.
Examination tools for TAVI (Transcatheter Aortic Valve Implantation) include risk scores like the Euroscore and STS score, which help in measuring surgical risk, along with imaging techniques and judgment of the clinical team.
Echocardiography is the main imaging technique used to confirm the severity of stenosis and evaluate the valve anatomy. Additional tests include CT scans, coronary angiography, and pulmonary functional tests.
Patients who are recommended TAVI (Transcatheter Aortic Valve Implantation) have severe symptomatic aortic stenosis, high or prohibitive surgical risk for open-heart surgery, anatomical suitability, reasonable life expectancy, and multidisciplinary team evaluation.
| Procedure Name | Transcatheter Aortic Valve Implantation (TAVI) |
|---|---|
| Type of Surgery | Minimally invasive catheter-based surgery |
| Type of Anesthesia | Local anesthesia/Conscious sedition |
| Procedure Duration | 1-2 hours |
| Recovery Duration | Few weeks |
Transcatheter Aortic Valve Implantation (TAVI): Pre-Op & Post-Op Care
Pre-operative care: Preparation before the TAVI Procedure
Patients undergo heart examination tests, namely, an electrocardiogram, echocardiogram, computed tomography, coronary angiogram, and a separate coronary angiogram to ensure heart and arterial anatomy.
Patients need to stop taking certain medications, such as aspirin and warfarin, unless approved by a cardiologist. Patients are advised to fast for at least 6 hours before the TAVI (Transcatheter Aortic Valve Implantation) procedure, and avoid drinking anything for 2 hours.
In-depth imaging, such as multi-detector computed tomography (MDCT), is done for the aortic valve and vascular evaluation to plan the valve size and procedure approach.
If patients have any known drug allergies, they must inform their cardiologist. This pre-operative planning for the TAVI (Transcatheter Aortic Valve Implantation) procedure ensures the assessment of arterial access and valve anatomy to minimize complications.
Intra-operative care: TAVI (Transcatheter Aortic Valve Implantation) Procedure
TAVI (Transcatheter Aortic Valve Implantation) is a minimally invasive procedure usually conducted under local anesthesia with sedation, but general anesthesia has also been used on some patients.
A catheter with a collapsed artificial valve mounted at the tip is introduced through the femoral artery or through a small incision or cut in the chest region.
The catheter is then guided to the aortic valve site, where the new valve is then deployed by either balloon expansion or self-expansion, pushing aside the old, damaged valves.
The new valve immediately starts regulating the blood flow. The catheter is then removed, and bleeding is stopped by pressure without sutures.
TAVI usually lasts for 1-2 hours with continuous monitoring of the vital signs.
Post-operative care: TAVI Surgery
Patients remain lying on their backs for about 6-10 hours to prevent bleeding from the place where the catheter was put inside the body.
Hospital stay lasts for 1-3 days, with close monitoring of the patient for vital signs, renal functions, bleeding, arrhythmias, and valve function.
Patients are then prescribed blood thinners for about 1-3 months and are scheduled for regular follow-ups. Cardiac rehab with exercise, diet, and changes in lifestyle is encouraged.
Patients are advised against lifting any heavy weights for 2-3 weeks and driving for 4 weeks.
Recovery from TAVI procedure is faster and less painful in comparison to open-heart surgery.
Benefits of Transcatheter Aortic Valve Implantation (TAVI) at Yashoda Hospitals
- Minimally invasive
- Reduced complications
- Faster recovery time
- Shorter hospital stay
- Improved quality of life
- Long-lasting results
- Safe alternative to open heart surgery
- Lower mortality rates
- Suitability with co-morbidities
Appointment
Second Opinion
WhatsApp
Call
More
