TRANSCATHETER AORTIC VALVE IMPLANTATION (TAVI)

Transcatheter aortic valve implantation is a “key-hole” treatment for aortic valve disease that avoids open heart surgery

What Is Transcatheter Aortic Valve Implantation All About?

Transcatheter aortic valve implantation (TAVI) may also be called transcatheter aortic valve replacement (TAVR) and is a minimally invasive treatment for aortic valve disease. A new aortic valve is inserted inside the diseased aortic valve without performing open heart surgery. This is usually accessed from the top of the leg (transfemoral or transcaval) but can also be undertaken from a small incision in the left lower chest (transapical) or left upper chest (transaxillary). 

The procedure is often undertaken in patients who are unsuitable or felt to be too frail for open heart surgery, but we are increasingly using it for younger and fitter patients who have weighed up the options of open heart surgery and TAVI.

How is TAVI performed?

This procedure is minimally invasive and is usually done to avoid the risks involved in open-heart surgery.  The procedure is not suitable for every patient, so before your cardiologist discusses TAVI, they will arrange some tests that will include a CT scan of your heart and blood vessels.  If you have other medical problems (such as lung disease or kidney disease) these may need investigating beforehand. 

The TAVI procedure is usually performed with local anaethetic and some medication to make you feel sleepy rather than a general anaesthetic.  A long thin tube is inserted, usually from the top of the leg and guided round to the heart.  A wire will be passed across the diseased valve and your heart will be paced to beat quickly whilst the new valve is passed across and inflated.  The old valve will be pushed to the edges of the blood vessel by the new expanded valve.  The tube is then removed and the blood vessel it was inserted through closed or repaired if the hole is larger.  In most cases the procedure lasts an hour or two. 

After the procedure, you will be monitored carefully for the next few hours.  If everything has gone well you may be able to go home the next day or the day after.  This is much quicker than having open heart surgery.  If you have a lot of other medical problems or there is a complication from the procedure you may be in hospital for a few days.

Potential risks of TAVI

Your expert Consultant Cardiologist will discuss the risks of TAVI based on detailed knowledge of your medical history and the findings of investigations but these include:

• 1-2% risk of death
• 1% risk of stroke
• 3-5% risk of needing repair (small operation or procedure) of the blood vessel the valve was inserted through
• 1% risk of kidney problems needing dialysis
• 1% risk of needing emergency heart surgery,
• 10-20% risk of needing a pacemaker

However, the risks of open heart surgery may be higher and your expert Cardiologist will discuss the pros and cons of different options with you.  If you have aortic valve disease that is causing symptoms there are risks of not having a procedure and your expert Cardiologist will discuss this and the timing of any procedures with you.

Schedule An Appointment

TAVI is a specialist procedure performed by our expert Consultant Cardiologists who are skilled in identifying the best treatment options for you as an individual.  Our expert Consultant Cardiologists are available for consultation on any day of the week and weekends as well.