treatment

Transcatheter Aortic Valve Implantation (TAVI), also known as Transcatheter Aortic Valve Replacement (TAVR), is a minimally invasive procedure used to replace a diseased aortic valve that has become narrowed (aortic stenosis). This procedure is an alternative to traditional open-heart surgery, particularly for patients who are considered high risk for conventional surgery.

What to Expect:

1. Initial Evaluation:
   • Medical History and Physical Examination: Comprehensive review of the patient’s medical history, symptoms, and risk factors for aortic stenosis.
   • Diagnostic Tests: Pre-procedural assessments including echocardiography, cardiac catheterization, computed tomography (CT) scans, and other imaging studies to evaluate the aortic valve and surrounding structures.
2. Treatment Plan:
   • Pre-Procedure Preparation: Patients may need to stop certain medications and follow specific dietary restrictions. A thorough assessment of the vascular access route (usually via the femoral artery) is conducted.
   • Procedure Details:
     • Access Route: The most common approach is through the femoral artery in the groin, though other access points (transapical, transaortic, or subclavian) can be used depending on the patient's anatomy and medical condition.
     • Valve Delivery: A catheter carrying the replacement valve is inserted into the artery and guided to the heart. The new valve is then positioned within the diseased valve and expanded, pushing the old valve leaflets out of the way.
     • Valve Deployment: The new valve begins to function immediately, ensuring proper blood flow from the heart to the rest of the body.
   • Anesthesia: The procedure is performed under local anesthesia with sedation or general anesthesia, depending on patient and procedural needs.
3. Surgical Procedure:
   • Duration: The procedure typically takes 1-2 hours.
   • Hospital Stay: Patients usually stay in the hospital for 3-5 days for monitoring and recovery.
4. Post-Treatment Care and Recovery:
   • Immediate Aftercare: Continuous monitoring in a recovery area or intensive care unit (ICU) for heart function, blood pressure, and any immediate post-operative complications. Pain management and observation of the access site.
   • Recovery Period:
     • First Few Days: Initial recovery involves rest and gradual increase in activity. Monitoring for potential complications such as bleeding, infection, or vascular issues.
     • Activity Restrictions: Patients are advised to avoid strenuous activities, heavy lifting, and driving for a short period. Specific instructions will be provided by the healthcare team.
     • Long-Term Recovery: Most patients experience significant symptom relief and improved quality of life within a few weeks. Full recovery may take several weeks.
   • Follow-Up Visits: Regular follow-up appointments to assess valve function, monitor for complications, and manage any other cardiovascular conditions.

What to Consider:

• Eligibility: Ideal candidates include those with severe aortic stenosis who are at high or intermediate risk for conventional open-heart surgery. Age, overall health, and the presence of other medical conditions are considered in determining eligibility.
• Risks and Complications: Potential risks include bleeding, stroke, heart attack, vascular complications, valve leakage (paravalvular leak), kidney injury, and complications related to anesthesia. Discussing these risks with the healthcare team is essential.
• Realistic Expectations: TAVI can significantly improve symptoms and quality of life. However, it is not a cure for aortic stenosis, and ongoing medical management and lifestyle changes are necessary.

Other Information:

TAVI is a relatively new but rapidly evolving procedure, offering a less invasive alternative to open-heart surgery with shorter recovery times and fewer immediate risks. It has become a standard treatment for high-risk patients and is increasingly being considered for intermediate-risk patients.