Transcatheter Aortic Valve Implantation (TAVI)

Cataloged Procedure

Transcatheter Aortic Valve Implantation (TAVI)

Transcatheter Aortic Valve Implantation (TAVI) is a minimally invasive procedure used to replace a narrowed or malfunctioning aortic valve in the heart without the need for open-heart surgery. It is typically performed on patients with severe aortic stenosis, a condition in which the aortic valve becomes stiff and narrowed, obstructing blood flow from the heart to the rest of the body.

TAVI is especially beneficial for patients who are at high risk for traditional open-heart surgery, such as elderly individuals or those with multiple medical conditions. It has become a preferred treatment for many patients who are not candidates for conventional surgical valve replacement.

Here's an overview of the TAVI procedure

Pre-Procedure Evaluation
Before the procedure, patients undergo a comprehensive evaluation to assess their overall health and determine the best approach for the procedure. Imaging tests, such as echocardiography and CT scans, are used to assess the anatomy of the heart and blood vessels. This helps doctors choose the appropriate size of the new valve and decide the most suitable access route for the procedure.
Anesthesia and Sedation
TAVI is typically performed under local anesthesia and sedation, although general anesthesia may be used in certain cases. The patient remains awake but relaxed during the procedure.
Accessing the Artery
The procedure is usually done through the femoral artery in the groin, though other access points, such as the subclavian artery (under the collarbone) or jugular vein (neck), may be used depending on the patient’s anatomy. A small incision is made to insert a catheter into the artery.
Catheter Insertion and Valve Delivery
A catheter, which is a long, flexible tube, is threaded through the blood vessels and guided to the heart. The catheter carries a prosthetic valve (artificial valve), which is typically mounted on a balloon or self-expanding device. Once the catheter reaches the aortic valve, the new valve is positioned inside the narrowed or damaged valve.
Deploying the New Valve
The prosthetic valve is deployed either by inflating a balloon (in the case of a balloon-expandable valve) or by allowing the valve to expand on its own (for a self-expanding valve). The new valve is then anchored in place, and the old, diseased valve is pushed aside.
Confirming Valve Function
After the new valve is in place, doctors use fluoroscopy (real-time X-ray imaging) and echocardiography (ultrasound) to confirm that the valve is properly positioned and functioning. If needed, minor adjustments are made.
Closing and Monitoring
Once the procedure is complete, the catheter is removed, and the access site is closed. The patient is closely monitored for any signs of complications, such as bleeding, infection, or issues with the newly implanted valve.

TAVI is commonly used to treat:

TAVI is primarily used to treat severe aortic stenosis, which can lead to heart failure and other serious complications if left untreated. It is recommended for patients who:

Are symptomatic with significant heart disease.
Have severe aortic stenosis but are considered at high or intermediate risk for open-heart surgery.
Have comorbid conditions that make traditional surgery too risky or unsuitable.

TAVI in the Treatment of Aortic Stenosis
Aortic stenosis occurs when the valve between the heart’s left ventricle and the aorta narrows, making it harder for the heart to pump blood into the body. Over time, this can lead to symptoms like shortness of breath, fatigue, chest pain, and even fainting. If untreated, aortic stenosis can result in heart failure and death. TAVI offers an alternative to surgery for these high-risk patients, providing an effective solution with lower risk and quicker recovery.

Post-TAVI Care and Follow-Up
After the procedure, patients typically stay in the hospital for a few days to monitor heart function, assess for potential complications, and manage pain. Long-term follow-up is necessary to ensure that the new valve continues to function properly and that there are no signs of complications such as valve dysfunction, infection, or leakage around the valve (paravalvular leak). Regular echocardiograms are used to monitor valve performance over time.

Dr. Dhiren R Shah, a highly experienced cardiologist since 1987, offers comprehensive cardiac care at his clinic. Equipped with advanced facilities

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