TAVI or TAVR (Transcatheter Aortic Valve Replacement) if you are from the USA, is a nonsurgical procedure to replace the aortic valve in your heart with a manufactured one. This minimally invasive procedure is offered to people of all risk levels. It’s an alternative to open-heart surgery (Surgical Aortic Valve Replacement (SAVR).
TAVI is a medical procedure that replaces the aortic valve in your heart without open-heart surgery. This minimally invasive procedure is now the most common way to replace an aortic valve.
Your aortic valve is the last of your heart’s four valves to handle blood flow. Your heart pumps oxygen-rich blood through that valve, to your aorta and out to the rest of your body.
Research shows that TAVI is usually safer and has either similar or better outcomes than SAVR. Replacement valves use cow or pig tissue in a metal frame.
Why might I need am AF Ablation?
The most common reason to undergo transcatheter aortic valve replacement is aortic stenosis. This is the narrowing of your aortic valve or the area around it. Narrowing usually comes from:
• Age-related wear and tear (especially if you’re over age 70) that can result in calcium buildup and/or thickening of the valve.
• Other health conditions, like rheumatic heart disease or bicuspid aortic valve, that can speed up degeneration of the valve.
Narrowing of the valve limits how much blood flows out to the rest of your body, forcing your heart to pump harder to make up for it. That usually leads to long-term damage to your heart muscle and then heart failure.
Many people who need aortic valve replacement are “high-risk” because of the severity of the stenosis or other health conditions. That means they have a greater risk of complications or death from a major surgery like open-heart surgery.
People at other risk levels can have a transcatheter aortic valve replacement, too.
Having a minimally invasive procedure has some advantages over a surgical procedure. But your doctor will consider your specific situation to decide if this procedure is right for you.
At the beginning of the procedure, you’ll receive either moderate sedation (most common) or general anesthesia (less common). Both use medicine to keep you from feeling pain, but the effect of moderate sedation isn’t as strong. Also, with moderate sedation, you don’t need a tube in your throat for a breathing machine (ventilator). For general anesthesia, a provider places a tube in your throat and connects it to a breathing machine. A provider removes the tube once the procedure is over.
You’ll also receive medicine to prevent blood clots.
During a TAVI procedure, an interventional cardiologist will:
1. Make a small cut (incision) and insert a thin tube (catheter) into the femoral artery at your upper thigh. They can use a different entry point if they need to, but this one is the most common.
2. Thread the catheter up to your heart.
3. Place the new valve inside your old aortic valve and expand it. The new valve should fit into place and stay there. The old valve will stay behind the new one that pushed it aside.
4. Check for leaks and other issues.
5. Remove the catheter device from your body.
6. Stitch the entry point closed and bandage it.
A TAVI procedure typically takes about an hour or two from start to finish.
Risks:
With advancements in valve and catheter technology, complications are rare. They include:
• A disruption in your heart’s electrical system that requires a pacemaker
• A leak around the outer edge of the new valve
• Stroke
• Bleeding
• Infection
• Heart attack
• Kidney, heart or blood vessel injury
• Low blood pressure
• Damage to the aorta
• A need for follow-up surgery
• Reactions to anesthesia or other medications you might receive during this procedure
Benefits:
TAVI has several advantages compared to surgery. This is why it’s now the most common method for replacing aortic valves. Some of those advantages include:
• Less invasive than surgery. Most surgeries on your heart involve larger incisions in your chest. Surgeons also often have to lift — or even crack and spread open — your rib cage to do heart surgery. TAVI involves one small incision only, with no need to move any of your internal organs or ribs.
• Easier recovery. Limiting the number and size of the incisions also means there’s less healing for your body to do. That leads to less pain and an easier recovery.
• Shorter hospital stays. Heart surgeries usually involve a hospital stay that lasts several days. Your provider may send you home the same day or the next day after TAVI. That depends on what time you had your procedure, the severity of your case and your overall health.
After the TAVI procedure is over, the cardiologist will stop the anesthesia or sedation so you can wake up. But they’ll keep you in bed for several hours (at the very least) to prevent bleeding. That’s because the entry point for the catheter was a major blood vessel, and they want to make sure the stitches are secure before you get up.
The cardiologist may prescribe medicine to keep you from getting an infection or blood clot after the procedure.
Most people who have TAVI can leave the hospital within one day. Some may stay two days or more. The overall recovery time can vary depending on your case and your overall health.
You can expect to have checkups with a provider a month after the procedure and once a year after that. Your cardiologist is the best person to tell you how long your recovery is likely to take. In general, most people can start resuming most of their normal activities within days of the procedure. For some, it may take a little longer.
You’ll need to wait one week (or more, depending on where your provider put the catheter in) before moving heavy items or doing other physical activity. You can go back to work two weeks after TAVI and drive after one month of recovery. Complete recovery takes six to 10 weeks.
Your cardiologits will likely refer you to a cardiac rehabilitation program. This is like a prescribed workout plan that involves a team of providers from several different fields. You’ll start this within several days of your TAVI procedure to increase your heart’s strength and endurance.