An Overview of Transcatheter Aortic Valve Implantation TAVI: What You Need to Know

02/15/2024

Transcatheter aortic valve implantation (TAVI) is a treatment for replacing an aortic valve that has narrowed and is unable to open fully. The aortic valve connects the left lower heart chamber to the body's main artery. The narrowing of the aortic valve is known as aortic valve stenosis. The valve malfunction prevents or delays blood flow from the heart to the body. TAVI is a minimally invasive procedure that uses smaller incisions than open-heart valve surgery. It may be a possibility for those who are unable to undergo cardiac surgery to replace their aortic valves. TAVI provides relief from chest pain, shortness of breath, and other symptoms of aortic valve stenosis. The decision to do TAVI is taken after consulting with a team of heart specialists and surgeons. The team works together to figure out the best treatment choice for you. 

What is a TAVI?

TAVI is a medical acronym (name) for the transcatheter aortic valve implantation operation. Transcatheter aortic valve implantation is also known as transcatheter aortic valve replacement (TAVR). It improves blood flow in your heart by replacing an only partially open aortic valve.TAVI is also known as Transcatheter Aortic Valve Replacement (TAVI). TAVI and TAVR are the same procedures; they simply have different nomenclature. 
TAVI is a common and relatively painless technique. A narrow flexible tube (known as a catheter) is inserted into a blood vessel in your upper leg or chest and guided to the aortic valve in your heart. The tube is used to install a replacement valve on top of the one you have currently.

Why would you need a TAVI?

If you have aortic stenosis, your aortic valve is unable to open completely. Your heart valves help maintain blood flowing through your heart. The aortic valve opens, allowing blood to flow from your heart into your aorta. The aorta is a large conduit that supplies your body with oxygen-rich blood.
If you suffer from severe aortic stenosis, your aortic valve may need to be replaced. TAVI was initially utilized as an alternative to heart valve surgery for patients who were unable to undergo open heart surgery to replace their aortic valves. TAVI patients often have a shorter hospital stay than those who undergo cardiac surgery to replace the aortic valve. Your doctor may suggest TAVI if you have Severe aortic stenosis symptoms include chest pain and shortness of breath. A biological tissue aortic valve that is not performing as expected. Another medical problem, such as lung or kidney illness, makes open-heart valve replacement operations risky.

To determine whether TAVI is correct for you, you may have one or more of the following tests:

• Blood tests.
• Echocardiogram
• ECG and CT scans
• Coronary angiogram
• Transesophageal echocardiography (TOE)
• Chest X-Ray
• Breathing tests

Many people are afraid of having tests because they think they may hurt, however, the examinations are usually quick and painless. Your doctor or nurse will explain each test and answer any questions you may have.

What are the benefits of TAVI? 

The benefits and dangers of TAVI are unique to each individual and are determined by the severity of your aortic stenosis, age, and overall health. TAVI can provide the following benefits:

• Relief or reduction in discomfort (if you have angina)
• Relief from or reduction in dyspnea
• Relief from or reduction in weariness
• Benefits include reduced dizziness and fainting, as well as increased energy. Better blood flow to your heart makes daily work and physical activity easier and more enjoyable.
• Improved mood and mental wellness.
• Decreased risk of cardiac failure and death

TAVI offers several advantages over open heart aortic valve surgery, including:

• Lower risk of mortality and strokes
• A shorter hospital stay leads to a faster overall recovery

Consult your doctor about the benefits and risks of a TAVI, as well as any concerns you may have.

How to prepare before a TAVI procedure

Preparing for a TAVI surgery will help alleviate any worry or anxiety you may experience. It can help you lower your risk during the surgery and recover faster. Preparation can include:

• Arranging for an attendant to be with you while you recover 
• Organizing transportation to and from the hospital, scheduling time off from work or other duties, and maintaining medication regimen.
• Eat healthful foods 
• Managing Your Weight
• Stop smoking
• Looking after your mental health
• Maintaining healthy teeth and gums through physical activity.
• Getting a check-up with your dentist—to lower your risk of endocarditis

What happens during a TAVI?

Average Time Taken For TAVI: 1-2 Hours A TAVI surgery typically takes between one and two hours, however, it may take longer in some circumstances. During the procedure, you will normally be awake but will be sedated and given local anesthesia. Very seldom, you may be put under general anesthesia.

Before The Procedure: 

• You will be asked not to eat or drink for four to six hours before the TAVI procedure.
• You'll change into your gown and be asked to remove any jewelry that could get in the way.
• You will normally be awake and resting on your back throughout the TAVI. You will be given a medication called a sedative to help you relax.
• You will receive a local anesthetic injection to relieve pain in your upper leg and under your collarbone.

During The Procedure: 

• A thin tube (the catheter) is then introduced into your artery via the numbed area.
• The tube is then pushed into the opening in your aortic valve, and a new valve, composed of metal and animal tissue, is placed inside the old valve.
• The valve either expands on its own or a balloon at the end of the catheter tube can be blown up to make room for the new valve.
• Your healthcare team will continuously monitor you throughout the process. 
• If you feel unwell or have chest pain at any time, please notify the staff.

After The Procedure:

• The catheter tube is removed, and there may be some bleeding.
• You will then return to the recovery area and, a few hours later, be transferred to the ward.
• You normally leave the hospital after a day or two, but discharge times can vary for everyone.
• You may experience bruising or pain in the location where the catheter tube was inserted. This should go off after a few days.
• When you arrive home, inspect the area where the catheter tube was inserted. You should consult your physician if you have any symptoms including redness, swelling, discomfort, bruising, or fever.

Precautions After Surgery: 
Typically, you'll be told not to lift, drag, or push anything heavy (such as a vacuum) for

• One week if you have your TAVI operation through your upper leg.
• Six weeks if you have your TAVI treatment through your chest.

When you leave the hospital, you will be given medicine to prevent blood clots. Recovery time from a TAVI surgery varies by individual. Most people need six to ten weeks to feel completely recovered. A few weeks following the treatment, you will likely have a follow-up appointment with a cardiologist at the TAVI center.

Risks
All operations and medical procedures have some level of risk. The potential dangers of transcatheter aortic valve replacement (TAVI) may include:

• Bleeding
• Blood vessel issues
• Issues with the new valve, such as falling out of place or leaking
• Stroke
• Heart rhythm issues and the requirement for a pacemaker
• Kidney disease
• Heart attacks and infections.
• Death

Conclusion 

TAVI is a minimally invasive alternative for people who are considered high-risk for regular open-heart surgery. While this blog covered the fundamentals, remember that individual requirements and concerns are critical. Consult your doctor to discover if TAVI is suited for you, and embark on an informed road towards possibly healthier days to come.