TAVI – Transcatheter Aortic Valve Implantation
A Non Surgical Cutting
Edge Technique For Aortic Stenosis
What is Aortic
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.
Aortic stenosis is a common & serious valve disease problem.
It is a narrowing of the aortic valve. The aortic valve allows blood to
flow from the heart’s lower left chamber into the aorta and then to the entire
body. Stenosis prevents the valve from opening properly, forcing the heart to
work harder to pump blood through the valve. This causes pressure to build up
in the left chamber and thickens the heart muscle.
Initially, your heart compensates the right pressure but after
some time it won’t be able to keep up the extra effort of pumping blood through
the narrowed valve. This can lead to heart failure.
How is it diagnosed?
Historically the treatment for this has been Surgical Aortic Valve
Replacement; this requires long hospitalization and rehabilitation. But now
this new therapy available that may help you get back on your feet faster. This
is called TAVI, also called TAVR (transcatheter aortic valve
replacement), and it is a less invasive procedure that is designed to replace a
diseased aortic valve.
Initially, this procedure used to only be available for people who
were too weak to undergo open-heart surgery. But now, TAVI is available
for most patients.
Symptoms of aortic stenosis may include:
Chest pain (angina), pressure or tightness in the chest
Fainting (temporary loss of consciousness caused by a fall in
blood pressure), referred as “syncope”
Palpitations or a feeling of heavy, pounding, or noticeable
Reduction in activity level or reduced ability to perform normal
activities which require only mild effort
This is diagnosed by Echocardiography (2D Echo) on echocardiogram
the Aortic leaflets may be thickened. With progressive stenosis the Aortic Valve area also
reduces. The pressure of the valve is also increased (marker of severity).
Aortic stenosis is graded mild, moderate and severe. Aortic valve replacement is
only done for severe aortic stenosis.
What happens during TAVI?
This minimally invasive surgical procedure repairs the valve
without removing the old, damaged valve. Instead, it wedges a replacement valve
into the aortic valve’s place. The surgery may be called a transcatheter aortic
valve replacement (TAVR) or transcatheter aortic valve implantation (TAVI)
TAVI procedure: step-by-step
This procedure depends on your health and your doctor will decide
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 from 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
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.
Dr. Sameer Gupta
There are multiple different valves currently available. The type
of valve required is individualized to the patient depending on the anatomy.
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 place.
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.
Patients may feel relief from their symptoms soon after their TAVI
procedure done, but others may take a little longer to get back to normal. Talk
to the doctor about how long your recovery may take.
The patient only requires 2–3 days of hospitalization and is
usually walking the next day. This cutting edge procedure is now available at
MD, FACC, FSCAI
Director, Interventional Cardiologist
For appointment, Call: 9910488465