Transcatheter Aortic Valve Implantation (TAVI)

Introduction

Transcatheter Aortic Valve Implantation (TAVI), also known as Transcatheter Aortic Valve Replacement (TAVR), is a minimally invasive procedure to replace a narrowed aortic valve due to aortic stenosis. It is typically recommended for patients who are at intermediate or high risk for open-heart surgery.

Indications for TAVI

TAVI is primarily indicated for: - Severe symptomatic aortic stenosis - Patients considered too high-risk for open-heart surgery - Older adults with frailty or multiple comorbidities

How the Procedure Works

  1. A catheter is inserted through the femoral artery (or another access point).
  2. A collapsible replacement valve is delivered to the heart.
  3. The new valve is expanded inside the diseased valve.
  4. The replacement valve takes over the function of the old valve, restoring normal blood flow.

Benefits of TAVI

  • Less invasive than traditional surgery
  • Faster recovery time
  • Improved quality of life
  • Effective for high-risk patients

Risks and Considerations

  • Stroke or vascular complications
  • Paravalvular leakage
  • Need for pacemaker implantation
  • Risk of infection or bleeding

Post-Procedure Care

Patients usually recover within a few days but require long-term monitoring. Lifestyle changes, medication adherence, and cardiac rehabilitation may be recommended to improve outcomes.

Source recommendations

1. 2021 ESC/EACTS Guidelines for the Management of Valvular Heart Disease

  1. https://pubmed.ncbi.nlm.nih.gov/34453165/
  2. https://academic.oup.com/eurheartj/article/43/7/561/6358470
  3. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Valvular-Heart-Disease-Guidelines
  4. https://www.jacc.org/doi/10.1016/j.jacc.2023.05.061
  5. https://www.eacts.org/clinical-practice-guideline/esc-eacts-guidelines-for-the-management-of-valvular-heart-disease/

2. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease

  1. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000923
  2. https://pubmed.ncbi.nlm.nih.gov/33332149/
  3. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000932
  4. https://pubmed.ncbi.nlm.nih.gov/33342586/
  5. https://www.jacc.org/doi/10.1016/j.jacc.2020.11.035

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