What is TAVI (Transcatheter Aortic Valve Implantation)?
BDS (Bachelor of Dental Surgery), 6 years of experience
What is TAVI (Transcatheter Aortic Valve Implantation)?
TAVI (Transcatheter aortic valve implantation) is a less invasive treatment modality for severe aortic valve stenosis. Aortic valve is one of the four valves or the leaflets present in our heart, which opens and closes when the heart beats and regulates the blood flow in the body. Aortic valve stenosis is a serious heart condition where the aortic valve gets stiff, which makes it difficult for the heart to pump the blood properly. This affects the overall health of the person.
In recent times, TAVI is increasingly being used as an alternative treatment to open heart surgery in nearly all patients. This is because of the lesser risks involved and increased durability of the valves used in the TAVI procedure, compared to the valves implanted in the open heart surgery. TAVI is a suitable option for patients who cannot undergo open-heart surgery due to the high complications and risks involved with open heart surgery. TAVI is also known as TAVR – Transcatheter Aortic Valve Replacement.
Let us explain in detail about TAVI (Transcatheter aortic valve implantation) in today’s article.
- What is the purpose of transcatheter aortic valve implantation (TAVI)?
- What are the tests done for transcatheter aortic valve implantation (TAVI)?
- What is the procedure of transcatheter aortic valve implantation (TAVI)?
- What are the steps of care for transcatheter aortic valve implantation (TAVI)?
- What are the risks of transcatheter aortic valve implantation (TAVI)?
- What is the advantage of transcatheter aortic valve implantation (TAVI)over open heart surgery?
- What is the cost of transcatheter aortic valve implantation (TAVI) in India?
What is the purpose of transcatheter aortic valve implantation (TAVI)?
Transcatheter aortic valve implantation (TAVI) is done in patients suffering from severe symptoms of aortic valve stenosis. The purpose of transcatheter aortic valve implantation is to replace the stenosed or calcified aortic valve with the new durable valve. This helps to relieve the symptoms of aortic valve stenosis.
Transcatheter aortic valve implantation (TAVI) maybe recommended and performed by the heart specialist doctor when the patient has the following signs or symptoms-
- Abnormal heart sounds or heart murmurs that are heard through the stethoscope
- Chest pain or angina where there is chest tightness experienced with physical activity. ( Know more about- Home remedies for Chest Pain )
- Palpitations or rapid heartbeats felt by the patient
- Shortness of breath or difficulty in breathing after any physical activity
- Fainting episodes or dizziness after any physical activity. ( Know more about- What is Dizziness? Home remedies for Dizziness )
- Tiredness or fatigue feeling after increased physical activity
- Swollen ankles and feet
- Difficulty in sleeping.
What are the tests done for transcatheter aortic valve implantation (TAVI)?
The doctor may ask the patient to undergo the following tests before the TAVI procedure-
- Chest X-rays– This is the imaging technique used to view the images of the internal organs like heart, lungs, etc. before the procedure of TAVI.
- Transthoracic echocardiogram (TTE) – Also known as Echo, this is the ultrasound technique used to get the 3-D images of the heart.
- MRI- This test also gives detailed pictures of the heart.
- Pulmonary/ Lung function tests- These tests are done to measure the capacity and functioning of the lungs. They measure how well the lungs are able to supply oxygen to the blood.
- CT scans- This is the X-ray technique where a contrast medium is injected into the blood vessels through the IV line and detailed pictures of the heart and blood vessels are taken.
- Angiogram- Another imaging technique that uses X-rays and dyes to view how well the blood flows through arteries and veins.
What is the procedure of transcatheter aortic valve implantation (TAVI)?
Transcatheter aortic valve implantation is performed to replace the damaged aortic valve.
The steps of the TAVI procedure are-
- The patient is sedated with the help of anesthesia (numbing agent).
- A small incision or cut is made in the groin region of the leg, where the femoral blood vessels (femoral artery and femoral vein) are located.
- Through the femoral artery, a small hollow tube known as the catheter is directed towards the heart using advanced imaging techniques.
- This is followed by inflating the balloon that is attached to the catheter tube. This helps in making space for the new valve that has to be implanted.
- The damaged valve is then replaced with a functional valve.
- The balloon attached with the catheter is then deflated.
- The old existing valve holds the new valve in place. The new valve then functions as the normal aortic valve. This is then monitored by the doctor.
- The doctor closes the incision at the groin after removing the catheter. This is known as the trans-femoral approach.
The procedure of transcatheter aortic valve implantation (TAVI) takes around 60-90 minutes, whereas an open-heart surgery can take up to 4 hours. ( Know more about- What is Aortic valve surgery? )
What are the steps of care for transcatheter aortic valve implantation (TAVI)?
Here are some measures to be considered and followed after TAVI procedure-
- One must set realistic recovery goals. One must consider factors like age, heart health and general health and set some recovery goals after talking with the doctor. Healthy diet plan and exercises recommended by the doctor helps with this.
- Pain medications should be taken as prescribed by the doctor as there might be pain at the catheter insertion site. Pain gradually reduces as the incision site heals.
- Cardiac rehabilitation- This helps in faster recovery and should be followed after consultation with the heart doctor.
- One must start physical exercises gradually. Doctors ask to start with short periods of walking after the procedure. Physical activities like climbing stairs, lifting things, etc should be strictly followed as per the doctor’s instructions. It may take several weeks to months before you can return to daily activities completely.
- Medications to prevent blood clots around the new valve are given by the doctors. One must take medicines on time.
- Follow a healthy diet, which includes lots of fruits, green vegetables, whole grains and healthy proteins. One must limit extra salty or fatty food items.
- Watch for complications like fever, rapid heartbeats, flu like symptoms, chest pain, shortness of breath, change in the color of the leg, etc. Contact the doctor immediately if you have any of these complications after the procedure.
- Regular follow-up checkups should be followed and the patient must visit the doctor as planned by the doctor. This will help check the progress of recovery and success of the valve replaced.
What are the risks of transcatheter aortic valve implantation (TAVI)?
Transcatheter aortic valve implantation (TAVI) may involve some risks which are as follows-
- Bleeding– This occurs during or after the procedure.
- Valve leaks– Sometimes the new valve replaced may not be big enough or may not fully expand. Thus, there may be blood leaking around the new valve.
- Endocarditis– This is the infection of the inner lining of the heart.
- Stroke– This is a very rare complication that may happen during or few days after the TAVI procedure.
- Kidney failure– This is a reversible kidney problem and mainly occurs due to the contrast dye used in the imaging tests for TAVI. ( Know more about- What is Acute Kidney Failure? )
- Vessel damage– This happens due to the damage of the blood vessels through which the catheter tube is passed.
What is the advantage of (transcatheter aortic valve implantation) TAVI over open heart surgery?
The main advantage of TAVI is that the heart need not be stopped. In this procedure there is no need to make a large cut or incision in the chest and heart-lung bypass machine is not needed. This means that the patient is put under less strain and recovery is faster compared to open heart surgery. Also, TAVI is a more suitable treatment option for patients who are too weak for open heart surgery. ( Know more about- Heart Bypass Surgery )
What is the cost of transcatheter aortic valve implantation (TAVI) in India?
The total cost of transcatheter aortic valve implantation (TAVI) in India can range from around INR 19,00,000 to INR 25,00,000. There are many large hospitals and experienced doctors in India who perform transcatheter aortic valve implantation. The cost of transcatheter aortic valve implantation may vary across different hospitals. The new durable valve which replaces the damaged valve requires expensive equipment.
If you are coming from abroad, the cost of transcatheter aortic valve implantation (TAVI) will have an additional cost of staying in the hotel, cost of local travel along with the cost of the transcatheter aortic valve implantation procedure. Apart from that, after the surgery the patient is advised to stay in the hospital for 3 days and in the hotel for 7 days for recovery. So, the total expenses can range upto INR 28,00,000.
We hope that we could answer your questions regarding TAVI (transcatheter aortic valve implantation) or TAVR (Transcatheter aortic valve replacement) through this article.
If you need more information about TAVI (Transcatheter Aortic Valve Implantation), you can contact a Cardiologist.
We only aim to give you information through the article. We do not recommend medication or treatment in any way. Only a doctor can give you the best advice.
