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TAVI

TAVR/TAVI is a catheter-based procedure used to replace a narrowed or damaged aortic valve through a minimally invasive approach.

ABOUT THE SERVICE

Transcatheter Aortic Valve Replacement/Implantation

Transcatheter aortic valve replacement (TAVR) is a minimally invasive heart procedure to replace a thickened aortic valve that can’t fully open (aortic valve stenosis). The aortic valve is located between the left lower heart chamber (left ventricle) and the body’s main artery (aorta). If the valve doesn’t open correctly, blood flow from the heart to the body is reduced.

Types of TAVR Approaches

Types of TAVR Approaches
Types of TAVI Valves

Types of TAVI Valves

The Medtronic CoreValve and Edwards' SAPIEN are the most commonly used TAVR prosthetic valves.

  • SAPIEN Valve

  • CoreValve

Before the Procedure

  • Before the day of surgery, you will have a physical examination and tests, including X-rays, CT scans, lung tests, and blood tests.

  • You will have an echocardiogram to evaluate your aortic valve. A cardiac catheterization may also be performed.

  • Tell your doctor if you are allergic to any medications.

  • Do not eat or drink for a few hours before surgery.

  • Remove jewellery and other objects that may interfere with the procedure.

  • Change into a hospital gown and empty your bladder before the procedure.

  • The surgical team will position you on the operating table and administer IV medications and fluids. Additional catheters may be placed to monitor your heart and blood pressure.

  • Before surgery, you may receive general anesthesia or moderate sedation, depending on your condition and the procedure.

Before the Procedure
During the Procedure

During the Procedure

  • Transcatheter aortic valve replacement (TAVR) replaces a damaged aortic valve with one made from cow or pig heart tissue (biological tissue valve).

  • Sometimes, the biological tissue valve is placed inside an existing biological tissue valve that is no longer functioning properly.

  • Doctors insert a catheter into a blood vessel, usually in the groin or chest, and guide it to the heart.

  • Moving X-ray images or echocardiogram images help the doctor position the catheter accurately.

  • The replacement valve is advanced through the catheter and positioned within the diseased aortic valve.

  • A balloon on the catheter may be inflated to secure the new valve in place. Some valves expand without balloon inflation.

  • The catheter is removed after the replacement valve is securely positioned.

  • Throughout the procedure, the anesthesiologist continuously monitors your heart rate, blood pressure, breathing, and oxygen levels.

  • A heart-lung machine is not required for this procedure.

Pacemaker

  • Every patient receives a temporary pacemaker during the TAVR procedure. A pacemaker is a device that uses electrical impulses to regulate your heart rhythm.

  • This involves a small wire passed through a vein in your leg into your heart, which is most often removed immediately after the procedure.

  • Sometimes, a permanent pacemaker may be needed after a TAVR procedure.

  • If a permanent pacemaker is required, it is usually placed while you are in the hospital, typically the day after your TAVR procedure.

Pacemaker
After the Procedure

After the Procedure

  • You will be taken to the intensive care unit (ICU) or recovery area for close monitoring after the procedure.

  • Your heart rate, blood pressure, breathing, and oxygen levels will be continuously monitored.

  • You may need to remain in bed for several hours after the procedure.

  • The catheter insertion site will be checked regularly for bleeding, swelling, or signs of infection.

  • Your doctor will advise when you can begin walking, eating, and returning to normal activities.

  • Most patients remain in the hospital for a few days before being discharged.

  • Follow-up appointments and echocardiograms are scheduled to monitor the function of the new valve.

TAVR Overview

TAVR Overview