TAVI / TAVR : A Revolutionary Non-Surgical Aortic Valve Replacement !!

TAVI / TAVR is a non-surgical replacement of diseased aortic valve.

UNDERSTANDING AORTIC VALVE

The heart pumps blood into the aorta which is the largest blood vessel in the body. The oxygen rich blood is carried from the aorta to different parts of the body and to all vital organs. Aortic valve is the gateway between the heart and the aorta and functions as a one-way valve.  As the aortic valve opens, the blood is pumped from the heart into the aorta. It then closes, so that the blood does-not exit back into the heart. The same cycle is repeated during every heartbeat.

WHAT IS AORTIC STENOSIS?

In some patients due to genetic predisposition, age, radiation exposure or other diseases, the aortic valve becomes thick and stiff. As time progresses, the valve degenerates further and causes a severe narrowing between the heart pump and the aorta. This is called aortic stenosis.

HOW DOES AORTIC STENOSIS AFFECT YOU?

Because of the obstruction to forward blood flow, with each heartbeat, excessive pressure starts building up inside the heart causing symptoms of breathlessness, fatiguability, giddiness, syncope, chest pain etc. If left untreated, it can cause recurrent heart failures and sometimes even sudden cardiac death.

WHAT ARE THE TREATMENT OPTIONS AVAILABLE?

Traditionally the only available cure was surgical replacement of aortic valve, where the surgeon through an open chest surgery will remove the diseased valve and suture a new artificial valve. The procedure is done in general anesthesia.

   With the ever-advancing technology, in the recent years it has been possible to implant a new valve without the nuances of open-heart surgery. This treatment is called transcather aortic valve replacement / implantation (TAVR/TAVI).

This treatment earlier was only approved for patients with high surgical risk because of their age or other co-morbidities. But in the last few years, TAVI is also approved for low surgical risk patients.

TAVI PROCEDURE – WHAT TO EXPECT.

The choice of anaesthesia would be as per your treating doctor, but usually the procedure is done under local anaesthesia or mild sedation.

The new aortic valve is delivered to the desired site through a small tube passed through the blood vessels in the thigh. The new valve is then opened up with a spring or a balloon. The valve start functioning as soon as it is deployed and the obstruction to the blood flow is removed immediately. The delivery system is then removed and the puncture site is closed with dissolvable sutures.

RECOVERY

The patient will be shifted to the ICU on the same day of the procedure and monitored for vital parameters. Patients are made to walk on the same or next day of the procedure and are usually discharged on day 4/5 of the procedure.

FOLLOW UP

Your first follow up visit will be after a week where a detail assessment of the newly deployed valve will be done.

There after according to patient’s clinical profile, you will be counselled regarding future follow up visits.