Transcatheter Aortic Valve Implantation
What is Transcatheter Aortic Valve Implantation?
Transcatheter aortic valve implantation (TAVI), also called transcatheter aortic valve replacement is a minimally invasive surgical procedure which involves replacing a damaged aortic valve with an artificial one without removing the old one. The new one is usually one made from pig or cow heart tissue.
The heart has four chambers, the upper two called the left and right atria (singular: atrium) and the lower two called the left and right ventricles. There are valves between two connecting chambers, such that blood flow is in one direction and does not reflux.
The left ventricle pumps blood to all parts of the body through a large artery called the aorta. There is a valve between the left ventricle and the aorta that allows blood flow in one direction without returning to the ventricle.
If the aortic valve is damaged and narrowed, the amount of blood that enters the aorta is reduced, in turn, causing the tissues of the body to lack enough oxygen and blood supply. This condition of the valve is called aortic stenosis and may present with chest pain, faintness, and breathlessness. Overtime, the narrowed valve may lead to heart failure.
When is a Transcatheter Aortic Valve Implantation done?
A transcatheter aortic valve implantation is recommended for individuals who have damaged and narrowed aortic valve who are already showing symptoms of poor tissue oxygenation and blood supply, and in whom an open heart replacement may be very risky.
How is a Trancatheter Aortic Valve Implantation performed?
You would lie on the procedure table and receive some medicines via an intravenous line made in your wrist or arm.
A transcatheter aortic valve implantation is a minimally invasive alternative to open heart surgery in which a large incision is made in the middle of the chest to gain access to the heart and replace the aortic valve.
TAVI is performed by a heart surgeon or cardiologist and involves passing a catheter through a blood vessel until it reaches the site of the aortic valve.
Your doctor could insert and pass the catheter to your heart through the femoral artery, an artery in your groin. This approach is called the transfemoral approach. A second approach which your doctor might employ is called the transapical approach which involves making small incisions in your chest and passing the catheter through the apex or tip of your left ventricle.
Once the catheter is in position, the replacement valve is passed through it to the site of the damaged aortic valve. When the new valve gets to the position, it is expanded so that it compresses the old one and takes up its role.
When the valve has been placed in position, the catheter is removed and the incision is sutured and dressed. You would be taken to the recovery room where you would be monitored for two to five days before you are discharged.
The advantage of a transcatheter aortic valve implantation compared to an open heart surgery is that there are no large incisions to worry about, the small ones made heal on time, you will recover faster, and you stay in the hospital for a much shorter period after the procedure.
What risks are associated with trancatheter aortic valve implantation?
TAVI carries a small risk of bleeding, stroke, irregular heartbeat, and dislodgement of the replacement valve.