What is TAVI?

Transcatheter Aortic Valve Implantation (TAVI) and Transcatheter Aortic Valve Replacement (TAVR) is a minimally invasive procedure involving placing the new valve inside the old and damaged one without removing the old valve. This surgery is a great substitute for people who can’t undergo open-heart surgery or have narrow valves. The entire procedure usually takes 1-2 hours.

Who needs TAVI?

The aortic valve is one of the four valves in our heart. The valves open and closes, allowing the flow of blood from one chamber to another and later to the entire body. The person who has a problem with their aortic valve and has a high risk of open-heart surgery are good candidates for TAVI.

Procedure

TAVI is a surgical procedure performed in an operation theatre. It involves the implantation of new valves made from animal tissues without removing the old and damaged valves. It a beneficiary option for patients who require valve replacement without undergoing massive open-heart surgery.

This surgery is performed via a very small opening, leaving the rest of the chest bones and muscles unaffected.

Transcatheter Aortic Valve Implantation

There are two approaches for performing the surgery. The doctor chooses the best suitable method depending on the patient’s condition and diagnosis.

  • Transapical Approach - Via making a small incision in the chest and entering through the largest artery or the apex of the left auricle.
  • Transfemoral Approach - Entering the through femoral artery without requiring any surgical incision in the chest.

Before the surgery,

  • You need to stop taking your usual medications according to your doctor’s consultations.
  • No eating six hours before the surgery.
  • Avoid drinking clear fluid such as water and without milk two hours before the surgery.

During the procedure,

  1. A small incision is made in the femoral artery in the groin.
  2. Contrast dye is injected and the procedure is monitored on the X-ray machine.
  3. A catheter, a thin tube-like structure is inserted into the artery and threaded towards the aortic valve.
  4. A catheter-based pace maker is placed on the right side of the heart for controlling the heart rate.
  5. The new valve is guided into the old and damaged valve.
  6. The implant is expanded so that it pins the flaps of the old valve out and takes over.
  7. The catheter and pacemakers are removed after the placement.

After the surgery,

The doctor will monitor the symptoms of the patient closely. Before discharge, the patient will be given detailed instruction on how to recover properly and faster. It is very important for the patient to follow the instruction and take medicines on time. If the patient continues to feel the signs and symptoms, it is advisable to visit the doctor without any delay.

Benefits of TAVI over SAVR

There are several potential benefits of minimally invasive TAVI surgery. The patient starts feeling better after the surgery. In some cases, the effects might start appearing after a bit longer than usual but all together patients report positive results, such as:

  • Being able to perform daily activities with higher energy.
  • Reduced anxiety
  • Normal breathing
  • Shorter hospital stays
  • Less pain

Difference between SAVR and TAVI

SAVR TAVR
Treats vascular complications and permanent pacemaker implantations. Treats lower risks strokes.
It is an open-heart surgery It is a minimally invasive procedure
Patients who undergo SAVR have more risk for blood transfusion, kidney injury and onset of atrial fibrillation. There are no such complications in TAVR but in some cases vascular complications may occur.

Risks and side effects

Though TAVI is a clinically safe and minimally invasive surgery with a faster rate of recovery, it does involve some risk which can after the health of the patient, like:

  • Kidney Impairment - The contrast dye used for imaging during the surgery have side effects on the kidney, though this risk is reversible in some cases.
  • Arrhythmias - In some cases, during the placement of the valve, the valves press the heart’s electrical system leading to abnormal heart rhythms, requiring a pacemaker.
  • Vascular Injury - In few cases, the blood leaks around the valves due to improper placements, calcium build-up or incomplete expansion of valves.

For TAVI, thus it is very important that one only approaches skilled and experienced doctor. Dr Rahul Gupta and Team Cardium are well known in India for TAVI / TAVR procedures and have helped countless patients to get back to their routine life without hassle.

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