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Transcatheter Aortic Valve Implantation – TAVI

Sep 21, 2017

About Your Heart

The human heart has four valves and the aortic valve is one of them. The aorta is the main artery carrying blood out of the heart. (When blood leaves the heart, it flows through the aortic valve, into the aorta.)

TAVI: Who is it for?

Transcatheter Aortic Valve Implantation (TAVI) is recommended for high-risk older patients who have Aortic Stenosis and are not suitable for open heart surgery. High-risk patients include those who have a calculated surgical risk – following the logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) – of over 20 per cent.

Why treat Aortic Stenosis?

Aortic Stenosis is a condition where the heart’s aortic valve becomes narrowed and does not open fully, forcing the heart to work harder to pump blood throughout the body. Some of the symptoms to look out for would be chest pain, shortness of breath, dizziness and loss of consciousness. The disease can be fatal if left untreated. More than half of symptomatic patients die within two years.

What is TAVI?

TAVI is a procedure that involves the insertion of an artificial heart valve called a Corevalve Device into the heart’s existing aortic valve. Its purpose is to expand the narrow pathways so that blood can flow through easily.

Once the valve has been opened up, a metal stent made of Nitinol (special metal alloy) secures the Corevalve Device in its intended position along with man-made valve leaflets that direct the flow of blood out of the heart smoothly.

The Corevalve Device is usually inserted through a small cut in the skin. There are four approaches by which TAVI is carried out:

  1. Transfemoral approach – The device is inserted through an artery around the hip area near the groin.
  2. Transapical approach – If the patient’s transfemoral arteries prove too small for the device, it can be inserted just under the left nipple between the ribs (apex). This allows the device to be inserted through the apex (tip) of the heart.
  3. Transaortic approach – The device is inserted into the aorta in the chest via an incision at the sternum (breast bone in the centre of the chest).
  4. Subclavian approach – The device is inserted into the subclavian arteries via an incision near the left shoulder, below the collar bone.

What are its benefits?

First and foremost, it offers patients stricken with Aortic Stenosis a new lease of life. They will be able to do things they could not do before, such as light exercise. Furthermore, the treatment extends a patient’s lifespan, free from the undesirable symptoms experienced before.

Important Pre-treatment Screening

Prior to TAVI, patients have to undergo a strict regime of tests to review their overall body and heart condition. This will also allow the doctor to determine which approach is best for each individual patient. T

These tests include:

  • Physical examination
  • Electrocardiography (ECG)
  • Chest X-ray
  • Blood Tests
  • Echocardiogram
  • Cardiac Catheterisation: includes Coronary Angiogram, Aortogram and other studies
  • Computed Tomography (CT) Scan
  • Other tests at the doctor’s discretion

What is the recovery period like?

Patients can expect to be fully awake within hours and resume talking as well as eating. Hospital stays usually last no more than a week with mobility achieved in four to five days, although this varies from patient to patient.