Transcatheter Aortic Valve Implantation (TAVI) Procedure

Introduction

Transcatheter Aortic Valve Implantation (TAVI), also known as Transcatheter Aortic Valve Replacement (TAVR), is a minimally invasive procedure for replacing a diseased aortic valve. It is commonly performed in patients with severe aortic stenosis who are at high or moderate risk for open-heart surgery.

Who Needs TAVI?

TAVI is typically recommended for patients who: - Have severe aortic stenosis, a condition where the aortic valve narrows and restricts blood flow. - Are considered high or intermediate risk for conventional open-heart surgery. - Have symptoms such as chest pain, shortness of breath, fainting, or fatigue.

How is TAVI Performed?

The TAVI procedure involves the insertion of a new valve through a catheter rather than open-heart surgery. The key steps include: 1. Accessing the Artery: A catheter is inserted through the femoral artery (groin), subclavian artery (chest), or other peripheral access points. 2. Guiding the Valve: The artificial valve is mounted on a balloon or self-expanding frame, guided to the diseased valve. 3. Placing the Valve: The new valve is expanded inside the diseased valve, pushing the old valve’s leaflets aside. 4. Confirming Placement: Doctors ensure the valve is correctly positioned and functioning before completing the procedure.

Benefits of TAVI

• Minimally invasive: No need for open-heart surgery.
• Faster recovery: Most patients recover in days rather than weeks.
• Improved quality of life: Relief from symptoms like shortness of breath and fatigue.
• Effective for high-risk patients: A good option for elderly or frail patients.

Risks and Considerations

Although TAVI is generally safe, some risks include: - Bleeding or vascular complications. - Stroke or transient ischemic attack (TIA). - Arrhythmias requiring pacemakers. - Valve leakage (paravalvular leak). - Kidney injury in susceptible patients.

Follow-Up Care

• Regular check-ups with a cardiologist.
• Medications such as blood thinners may be required.
• Lifestyle changes including a heart-healthy diet and exercise.

Conclusion

TAVI is a breakthrough procedure for treating severe aortic stenosis in patients where open-heart surgery is not the best option. Advances in technology continue to make it safer and more effective. If you or a loved one has been diagnosed with aortic stenosis, consult a cardiologist to determine if TAVI is a suitable option.

Source recommendations

1. American College of Cardiology: Aortic Stenosis Guidelines

1. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000923
2. https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2020/12/16/21/58/2020-ACC-AHA-VHD-GL-Pt-1-GL-VHD
3. https://pubmed.ncbi.nlm.nih.gov/33332149/
4. https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2024/03/13/18/13/2024-acc-aha-clinical-performance-valvular
5. https://www.jacc.org/doi/10.1016/j.jacc.2023.05.061

2. European Society of Cardiology: Valvular Heart Disease Guidelines

1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Valvular-Heart-Disease-Guidelines
2. https://academic.oup.com/eurheartj/article/43/7/561/6358470
3. https://pubmed.ncbi.nlm.nih.gov/34453165/
4. https://academic.oup.com/eurheartj/article/38/36/2739/4095039
5. https://pubmed.ncbi.nlm.nih.gov/17259184/