Transcatheter aortic valve implantation (TAVI) is a procedure used as an alternative to open heart surgery in treating severe aortic stenosis, a condition which is commonly found among elderly patients. It will be performed if the doctor feels that a patient would be put at risk by the more invasive open heart surgery. Aortic stenosis may cause symptoms ranging from chest pain and shortness of breath to heart palpitations and heart murmurs. Most people don’t need to treat their aortic stenosis until it’s severe and they start experiencing symptoms that affect their quality of life. At that point, treatment is necessary, as this condition can be deadly if left to progress.
TAVI is a minimally invasive procedure to replace the aortic valve in people with aortic valve stenosis. Aortic valve stenosis occurs when the heart's aortic valve thickens and calcifies, preventing the valve from opening fully, which limits blood flow from your heart to the rest of your body. Aortic stenosis can cause chest pain, fainting, fatigue, leg swelling and shortness of breath. It may also lead to heart failure and sudden cardiac death.
-Treatment TAVI helps to reduce complications, such as infection, as TAVI provides an alternative to the more invasive open heart surgery.
-Patients who receive TAVI can recover quickly, having received only a minimal incision.
-TAVI patients spend approximately 5-7 days recovering at the hospital, while patients who undergo the more invasive open heart surgery need approximately 7-10 days of recovery time.
-Risks of infection and bleeding are lower compared to traditional open-heart surgery.
-Despite the fact that this procedure is not as invasive as an open surgery, it still carries some risks with it.
The doctor will begin the implantation of an artificial heart valve by first inserting a catheter into the patient's body via the femoral artery (located in the groin), or by piercing the tissues at the apex of the heart through a small incision in the chest. When the catheter is guided towards and reaches the aortic valve, the doctor will then inflate a balloon within the catheter, placing pressure on the artificial heart valve and securing it in position. The new artificial heart valve will then replace the existing aortic valve as its condition continues to deteriorate. This procedure normally takes around 2-3 hours.
You'll be evaluated to make sure you don't have any risk factors that may affect you during the TAVI procedure. You may be given a medication to reduce the risk of infection prior to your procedure.
You may spend the night in the intensive care unit for monitoring after your procedure. Generally you'll spend about two to five days recovering in the hospital. You'll need regular follow-up appointments with your doctor after TAVI. You may need to take certain medications after your procedure. For example, you'll need to take blood-thinning medications to prevent future blood clots. Your doctor will discuss with you how long you may need to take these medications. Always take your medications as prescribed. Artificial heart valves, including a transcatheter aortic valve, can become infected with bacteria. Most bacteria that cause heart valve infections come from the bacteria in the mouth. Excellent dental hygiene, including routine dental cleanings, can help prevent these infections. Your doctor will recommend that you take medications before certain dental procedures to prevent infections. Your doctor may recommend that you make healthy lifestyle changes, such as eating a heart-healthy diet, exercising regularly, maintaining a healthy weight and avoiding smoking.
The risks associated with implanting an artificial heart valve using a catheter are as follows:
-Bleeding or blood clots formed under the skin, or infection at the site of the catheter
-Damaged blood vessels
-Acute kidney injury
-Thrombosis, which can cause stroke
-Irregular heartbeat (arrhythmia)
-Problems caused by the artificial heart valve becoming dislodged
-As with any form of heart surgery, there is always the risk of death
What kinds of patients are suitable for undergoing this procedure?
Patients who suffer from severe aortic stenosis. Elderly patients, especially those aged 80 or older. High-risk surgical patients; a doctor or treatment provider will assess the patient's surgical risk level based on certain criteria. Patients who are expected to live longer than 1 year, and are not in a stage of advanced cancer. Patients who suffer from a chronic condition such as severe atherosclerosis, or who have previously undergone heart surgery. Based on these criteria, a doctor will consider which method of treatment is suitable for each patient.
What is longer-term recovery like?
Most patients can go back to their normal lifestyle after a few days and return to regular activities much faster than with major surgery, which often requires up to a three-month recovery period.