What is TAVI?
TAVI is the acronym for Transcatheter Aortic Valve Implantation (TAVI). It is a cardiovascular procedure performed by interventional cardiologists and cardiac surgeons to replace a defective aortic valve.
It is performed percutaneously or through small incisions, thus avoiding open heart surgery and significantly reducing the aggressiveness of the procedure.
Why is TAVI performed?
The aortic valve is one of the four valves in our heart, and it opens and closes synchronously with the pumping of our heart. The blood that pushes the left ventricle with each heartbeat (systole) passes through the aortic valve into the aorta without resistance and from there the blood is distributed throughout the body.
When the valve is very narrow (severe aortic stenosis) there is great difficulty for the heart to push that blood. The result is that the patient begins to experience symptoms (shortness of breath or fatigue, oppressive chest pain or loss of consciousness) and also shortens life expectancy.
Whenever symptomatic severe aortic stenosis is diagnosed, replacement of the defective valve with a new valve that opens and closes properly is indicated.
TAVI procedures are particularly suitable for patients who are at high risk for conventional surgery, elderly patients and those with severe associated pathologies (liver, kidney, lung problems, etc.), or who are very fragile.
What does TAVI consist of?
TAVI is performed percutaneously or through very small incisions, i.e. it is not necessary to open the chest or use extracorporeal circulation. TAVI valves are biological valves mounted on a spring or stent that can be compressed to a very small size.
This valve mounted on the stent is introduced through one of the main arteries (femoral artery, axillary artery, carotid artery, aorta…) and is directed towards the diseased valve through the circulatory tree. Upon reaching the landing zone, and after making space with a balloon (valvuloplasty), the valve is deployed inside the patient’s own valve pushing it sideways into the correct position and starts functioning immediately.
Preparation for the TAVI procedure
To assess whether a patient with severe aortic stenosis is a good candidate for a TAVI procedure, it is necessary to be evaluated by a committee of experts in cardiology and cardiac surgery (Heart-Team), and to perform a series of tests: echocardiogram, catheterization and CT angiography of the aorta and extremities.
Outcomes after the procedure
The overall risk is currently low and complications of TAVI procedures have been decreasing over time. An embolic episode (2-3 % cases), a significant valve deployment defect (perivalvular leak) in 5 % of cases, a problem with the femoral artery (8 % of cases) or a heart rhythm block requiring pacemaker implantation (up to 15 % of cases) are possible.
After a TAVI procedure the stay in ICU and hospital is very short (3-5 days) and recovery after discharge is very fast. Once the intervention has been performed, the patient’s quality of life and life expectancy increase, with fewer hospital readmissions.
This definition has been drafted with the help of Dr. Ruyra Baliarda, expert in minimally invasive cardiac surgery, mitral insufficiency, aortic root surgery, mitral repair, bloodless surgery and TAVI catheter valve implants, among others.