TAVI: TRANSCATHETER AORTIC VALVE IMPLANTATION A LESS INVASIVE THERAPY FOR SEVERE AORTIC STENOSIS
You may feel overwhelmed if you have been recently diagnosed with severe aortic stenosis and this can make it harder to take the step toward treatment. But the sooner you seek care, the quicker you will be able to get back to life and all the things you love.
TAVI, also called TAVR (transcatheter aortic valve replacement), is a less invasive treatment option for severe aortic stenosis, that is designed to replace a diseased aortic valve.
This procedure used to only be available for people who were too weak to undergo open heart surgery. But now, TAVI is available to more people depending on their risk for open heart surgery.
A doctor can explain the procedure to you and determine if TAVI is right for you.
WHAT HAPPENS DURING TAVI?
Your doctor will perform the procedure at a hospital. Depending on your health, they will determine what type of anaesthesia is best for you. You may be fully asleep, or you may be awake but given medication to help you relax and block pain. Your heart will continue to beat during the procedure. This is quite different to open heart surgery, in which your heart will be stopped, and you will be placed on a heart and lung blood machine .
TAVI is different from open heart surgery in that it uses a less invasive approach to treat a diseased aortic valve. Your doctor will determine the best approach for replacing your valve, but the most common technique involves a small incision made in the leg. This is called the transfemoral approach.
TAVI PROCEDURE (STEP-BY-STEP):
A small incision is made in your upper leg. This is where your doctor will insert a short, hollow tube called a sheath into your femoral artery.
The new valve is then placed on the delivery system (or tube). The new valve is compressed to make it small enough to fit through the sheath.
The delivery system carrying the valve is pushed up to your aortic valve. Once it reaches your valve, the new valve pushes aside the leaflets of your diseased valve. Your existing valve holds the new valve in pace.
The new valve will open and close as a normal aortic valve should. Your doctor will make sure your new valve is working properly before closing the incision in your leg.
Your doctor may decide that a different approach is necessary depending on various factors. Other ways to perform the TAVI procedure include:
- Transapical approach: Through an incision in the chest between the ribs
- Transaortic approach: Through an incision in the upper chest.
- “TAVI.” Heart Treatments – British Heart Foundation, www.bhf.org.uk.
Post Procedure Care*
American Heart Association*
Post TAVI/ TAVR , Patients may not need more rest as compared to other procedures, they may actually spend 1-2 days in the ICU followed by hospital stay in the patient room for another 2-3 days.
Nearly all patients start walking in 1 day and can perform small activities in 2-3 days of the procedure, under doctor surveillance.
Before the Patients leave the hospital, they will be suggested to restrict some physical activities for few more days depending upon the condition and will also be advised when to re- visit the doctor after TAVR procedure.
To monitor the condition after TAVR, the patient should have a TAVR check for every 30 days to 1 year (as per the doctor’s suggestion). In case if they face any health changes and discomfort, make sure a visit to the doctor.