Transcatheter Aortic Valve Replacement

What is TAVI?

Transcatheter aortic valve implantation (TAVI) is an alternative to open heart surgery for patients with severe aortic stenosis (narrowed aortic valve). It is a minimally invasive procedure. The procedure involvesinserting a new artificial heartvalve inside the old tight valveusing a balloon catheter. Thevalve is made up of a metalframe (stent) and the outerlining (pericardium) of a cow’s heart. The procedure is carriedout under local or general anaesthetic.

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There are two common routes of new valve insertion:

1. Transfemoral – through the femoral artery, the main artery in your groin which leads back to the heart.

2. Transapical – through a small cut on the left side of your chest to get to the apex (tip) of your heart.

Who can have a TAVI?

At this time the procedure is reserved for those people for whom an open heart procedure is too risky. For that reason, most people who have this procedure are in their 70s or 80 and often have other medical conditions that make them a better candidate for this type of surgery.

Although relatively new, TAVI can be an effective option to improve quality of life in patients who otherwise have limited choices for repair of their aortic valve.

The decision to undertake conventional surgery or TAVI is made by a team of people, including the cardiologist or surgeon. The decision is often complex, and is always carried out in the setting of a multidisciplinary team meeting.

What are the risks of TAVI?

The risk of TAVI is generally lower than normal surgery but there are small risks associated with the procedure

Major risks

  • Bleeding or damage to the groin artery, need transfusion or surgery 1-2%
  • Stroke 2-3%
  • Heart Attack 1%
  • Death 3-5%
  • Kidney failure 2-5%
  • Emergency cardiac surgery 1%

Less serious risks

  • An abnormal heart rhythm
  • Bruising around the wound site
  • Need for a pacemaker after the procedure

For a visual representation of what the procedure involves, please watch the following video:

Procedure video

Patient experiences

 

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