TAVI / TAVR
Procedure

Transcatheter Aortic Valve Replacement — a state-of-the-art, non-surgical treatment to replace a narrowed aortic valve without open-heart surgery.

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What is TAVI / TAVR?

Transcatheter Aortic Valve Implantation (TAVI) is a procedure where a replacement aortic valve is deployed inside the diseased valve using a catheter. It is performed in a Cath Lab under fluoroscopic guidance, avoiding open chest surgery.

How it works

A procedure similar to coronary angioplasty:

Groin access (femoral artery) under local anesthesia
Crimped tissue valve is navigated up to the heart
Valve expanded to push old leaflets aside and take over flow
Catheter is removed—no sutures or chest bones cut

Clinical Benefits

No general anesthesia required in many cases
No heart-lung bypass machine necessary
Extremely rapid recovery—walk next day
Hospital stay reduced to 2 to 3 days
Ideal life-saving treatment for elderly patients

Aortic Valve Stenosis

Aortic stenosis is a progressive narrowing of the aortic valve opening, typically caused by calcium build-up in elderly patients. The heart has to pump much harder to push blood out to the body, eventually leading to heart failure, chest pressure, and severe breathlessness. TAVI provides immediate opening of the valve, offering rapid relief.

Tissue Valve Usage

Catheter valves are biological tissue valves (made of bovine or porcine pericardium). Because tissue valves degrade in 10-15 years, TAVI is perfect for patients over 70. Younger patients are usually recommended for open surgery with metallic valves, unless significant surgical risk factors exist.

Who is a Candidate for TAVI?

TAVI is an excellent option for patients where traditional open-heart surgery presents high risks.

Elderly Patients

Typically indicated for patients over 70 or 75 years of age, where avoiding major surgical trauma is beneficial for overall longevity.

Surgically Unfit

Patients labeled as high risk or unfit for open chest surgery by the Heart Team due to advanced weakness or heart muscle damage.

Comorbid Conditions

Associated medical conditions like severe lung disease (COPD), active malignancy, liver diseases, or advanced kidney failure.

Redo Valve Cases

Patients who had a surgical tissue valve in the past which has now failed, allowing a new catheter valve to be inserted inside it (Valve-in-Valve).

Important Considerations

While TAVI offers excellent ease and recovery, there are key trade-offs patients should discuss:

Higher Financial Cost

The transcatheter valve itself is a highly engineered bio-compatible device, making the total procedure cost significantly higher than traditional open-heart surgery.

Pacemaker & Leakage Risk

Because the new valve frame is pressed against the native tissue, it can compress the heart's electrical pathways, leading to a slightly higher rate of pacemaker implantation.

The 3-Day Recovery Timeline

Day 1: Cath Lab & Deployment

Done under local anesthesia/sedation. Groin puncture is sealed using percutaneous closure devices. Patients are monitored in the ICU/recovery unit overnight.

Day 2: Mobilization & Walk

Urinary catheter and lines are removed. The patient starts sitting up, drinking liquids, and walking short distances in the ward with help.

Day 3: Discharge & Home

A post-op 2D Echo is performed to check valve function. Patient is discharged home with minimal medication adjustments and returns to normal light life.

Frequently Asked Questions

Essential information regarding the TAVI / TAVR procedure.

Traditional open-heart surgery requires opening the chest by cutting the breastbone, stopping the heart, and placing the patient on a heart-lung machine. TAVI/TAVR is a catheter-based procedure performed in a Cath Lab. The new valve is crimped onto a catheter, inserted through a small artery in the groin, and guided to the heart, where it is expanded inside the diseased valve. There is no chest incision and no heart-lung machine.

Only bioprosthetic (tissue) valves can be used in TAVI. These valves are made of natural animal tissues mounted on a metal stent that can be compressed inside the catheter and expanded inside the heart. Mechanical metal valves cannot be compressed, and thus cannot be used in catheter procedures.

TAVI valves generally last between 10 and 15 years, which is comparable to surgical tissue valves. Because they are biological valves, they undergo gradual wear and tear over time. This is why TAVI is primarily recommended for older patients (over 70 years) or those who are high risk for surgery.

While TAVI is minimally invasive, it carries specific risks including a slightly higher chance of needing a permanent pacemaker (due to pressure on the heart's electrical pathways from the expanded valve frame), access site bleeding, vascular injury, or stroke. Dr. Amjad reviews your vascular anatomy thoroughly via CT scan to minimize these risks.

Recovery is very rapid. Patients are usually up and walking the day after the procedure. The total hospital stay is typically just 2 to 3 days, and patients can return to normal light daily activities within a week.

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Share your angiography and reports with Dr. Amjad. He will review them personally and guide you with the best possible treatment options.

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TAVI / TAVR Procedure