TAVI Procedure: Benefits, Risks, Treatment & Recovery

Transcatheter Aortic Valve Implantation (TAVI), or Transcatheter Aortic Valve Replacement (TAVR), is a cutting-edge, minimally invasive treatment option for aortic stenosis. It has become increasingly popular and is an important breakthrough in cardiovascular medicine. Sarvodaya Hospital, the best heart valve replacement centre in Delhi NCR & Greater Noida West offer a viable native artificial replacement valve as an alternative to open heart surgery through the non-surgical, minimally invasive procedure known as TAVI/TAVR. 

TAVI has become the preferred treatment strategy for symptomatic severe aortic stenosis among patients deemed to be at excessive or at high risk for conventional open heart surgery and has also become an alternative option among intermediate and low-surgical risk patients.

TAVI has been shown to significantly improve quality of life and increase survival rates for elderly patients not recommended for conventional open-heart surgery. In recent years, TAVI has become the preferred treatment option for many high-risk patients with aortic stenosis.

The success rates of TAVI procedures have been impressive and have shown promising results in reducing mortality rates in elderly patients with severe aortic stenosis, and improving quality of life and longevity after the valve replacement.

This less invasive approach promotes faster recovery and a lower risk of complications than open heart surgery.

What is TAVR/TAVI?

This minimally invasive innovative procedure involves inserting a catheter to place a replacement valve through a blood vessel into the heart, creating a small incision in the chest or groin without removing the damaged valve. The new replacement valve is then positioned within the old valve, without the need for open-heart surgery.

What is Aortic Valve?

The aortic valve is vital for maintaining proper blood flow through the heart. During systole (heart contraction), it opens to allow blood to be pumped into the aorta, and during diastole (heart relaxation), it closes to prevent blood from flowing back into the left ventricle.

This aortic valve is situated between the main artery of the heart and the left lower chamber of the heart. One of the four valves in the heart that regulate blood flow is the aortic valve. The aortic valve carefully controls blood flow from the heart to the rest of the body via the aorta.

Types of Aortic Valve Disease

Aortic stenosis and aortic regurgitation are the two main conditions that are included in aortic valve disease. 

Aortic Stenosis: This condition involves the narrowing of the aortic valve opening. This narrowing of the aortic valve does not open completely and restricts blood flow from the heart to the rest of the body, forcing the heart to work harder. The diseased aortic valve condition is referred to as aortic stenosis, which gives rise to catastrophic consequences like heart failure or sudden death and other problems like chest pain, shortness of breath, fatigue, and dizziness. This aortic stenosis condition may develop as a result of congenital heart disease or be acquired as a result of ageing. This life-threatening progressive cardiac disease is most common in patients over 60 years of age and upon severity can cause death.

Aortic Regurgitation: In this condition, the aortic valve fails to close properly, allowing blood to flow back into the left ventricle. This backflow can cause the left ventricle to become enlarged and overworked, resulting in symptoms like breathlessness, fatigue, and heart palpitations.

Why do I need TAVI?

TAVI is typically recommended for elderly patients who are too risky for open heart surgery. It may also be an option for people who are unwilling to undergo open heart surgery or who are scared of it. The Transcatheter Aortic Valve Implantation (TAVI) procedure replaces the damaged aortic valve and places the new replacement valve into the heart.

What are the benefits of TAVI?

In comparison with aortic open valve heart surgery (open heart surgery), the benefits of TAVI include:

• It is a safer and better alternative to open heart surgery.

• Patients typically experience faster recovery and shorter hospital stays compared to traditional surgery.

• Ideal for older patients who are at risk of open heart surgery or those who have undergone bypass surgery or with other symptoms that can easily be treated with TAVR/TAVI, which minimizes complications of death and stroke compared to aortic open heart surgery.

• Reduce the chances of heart stroke and improve treatment outcomes.

• Minimally invasive, non-surgical procedure with minor cuts on the body while inserting the catheter.
• Minimize the need for post-rehabilitation services.
• There is less blood loss, less pain, and less harm to body tissues.
• The patient recovers faster, gets early discharge from the hospital and resumes routine lifestyle activities.

Aortic stenosis is a severe medical condition. TAVI can also have benefits, reducing the chances of following diseases.

• Angina pain
• Breathlessness issue
• Fatigue or tiredness
• Dizziness & fainting
• Relief from general debility
• Heart failure & death

How do I prepare for the TAVI Procedure?

You should prepare for a TAVI procedure after a comprehensive evaluation by a medical and surgical team determines that a patient is healthy enough to undergo a Transcatheter Aortic Valve Implantation (TAVI) procedure and to follow the instructions before and after the TAVI procedure.

Before the TAVI Procedure:

• This evaluation includes reviewing your medical history and conducting electrocardiograms, echocardiograms, CT scans, X-rays, and blood tests.
• You are allowed to perform a cardiac catheterization test to assess the proper supply of blood to your heart through arteries.
• You are restricted from taking medicines for diabetes or blood-thinning anticoagulants at least 3 days before surgery. You should follow the doctor's instructions on which medicines to continue or stop before the TAVI procedure.
• You are asked not to eat or drink at least 4-6 hours before the procedure.
• Before the procedure starts, you are asked to remove any jewellery or other items that might interfere with the procedure and wear a hospital gown.
• You or your relatives are instructed to sign a consent form to agree to the procedure.

After the TAVI Procedure:

• Following the procedure, you are advised to stop smoking because it raises the risk of procedure failure and may cause lung issues.
• You are advised to stay in the hospital for a longer period for proper recovery and to lessen the chances of unexpected happenings. The majority of patients leave the hospital in 24 to 48 hours and return home, however, they should be given strict instructions on how to take care of the patient, including how to watch for pain or discomfort in the area where the catheter tube was inserted and seek medical help immediately in case of medical emergencies.
• Avoid pushing, pulling, or lifting anything heavy after the procedure.
• Arrange transportation to reach home safely.
• Make follow-up appointments with your cardiologist at Sarvodaya Hospital, the best hospital in Faridabad, to keep an eye on your recovery and valve function.

What Happens During the TAVI Procedure?

• Local Anaesthetic: A local anesthetic is administered to numb the area where the catheter has been inserted, typically in the groin or in the chest. The choice of administering Anaesthesia depends on patient’s overall health and doctor’s preference.

• Access: The femoral artery in the groin region is usually used for the procedure, but alternative access points can also be employed.

• Catheter Insertion: A thin, flexible tube, catheter is inserted into an artery through the numbed area. This catheter tube is taken out after completing the procedure.
• Placing the Catheter: The catheter is carefully passed into your heart in the region of the opening of aortic valve.
• Valve Positioning and Deployment: A new valve, made of metal and animal tissue, is positioned inside the old valve. The new valve either expands by itself or with the help of a balloon at the end of the catheter. This new valve is deployed permanently without removing the damaged aortic valve.
• Monitoring: Throughout the procedure, your heart rate, rhythm, oxygen levels, and blood pressure will be closely monitored by a heart specialist doctor.

How do I recover from the TAVI Procedure?

• Cardiac Rehabilitation: It is also known as cardiac rehab. A key component of heart recovery, it provides rehab nurse services that can promote cardiac health, prescribe appropriate personalized exercises, and educate on heart care.

• Medications: You will be given medications prescribed by a heart specialist doctor to help avoid blood clots, pain, or any inflammation that might have occurred after the procedure. You will also be discussed on a call regarding medication substitution if you have any serious issues that require the assistance of a cardiologist.

• Follow-up appointments with your best heart specialist doctor at the Cardiac Care Center, Sarvodaya Hospital, for faster recovery.

What is TAVI recovery time?

Each person's recovery journey is unique and varies from person to person. While some patients might feel back to normal relatively quickly, others may take a bit longer. On average, most people take about six to ten weeks to fully recover.

How successful are TAVI/TAVR procedure?

TAVI/TAVR procedure has proven to be highly successful in improving symptoms and enhancing the quality of life for most patients. After undergoing TAVI, many patients experience significant relief from symptoms such as shortness of breath, fatigue, and chest pain, allowing them to participate more fully in daily activities. However, it is important to note that the risk of complications can vary based on a person's overall health and specific heart condition.

• High success rate in treating aortic stenosis or heart valve disease.
• Lower mortality rate compared to traditional open heart surgery.
• Improved quality of life for patients after the TAVI procedure.

Treatment for Aortic Stenosis: Transcatheter Aortic Valve Implantation (TAVI/TAVR)

One of the most cutting-edge Transcatheter Aortic Valve Implantation (TAVI) centres in Delhi, NCR, and Greater Noida West is located at Sarvodaya Hospital, the best hospital in Faridabad.

The old-fashioned surgical method of opening the chest and performing the aortic valve replacement surgery is no longer used or hardly used with severe conditions. Today, this intricate procedure can be completed without surgery, avoiding any major tissue cutting with no visible scars.

With TAVI/TAVR, today, this intricate procedure can be completed without surgery, avoiding any major tissue cutting with no visible scars.

Conclusion