In India, almost 13% of the population is suffering from heart problems. The more serious cases such as severe aortic stenosis (narrowing of the heart’s aortic valve) might need an open heart surgery. The open heart surgery or surgical AVR is a high-risk, complex procedure to perform, especially on patients above 70 years of age. This number of elderly patients unable to go through surgical AVR or any other viable solution goes as high as 30-40%.
As a safer option for these high-risk patients, TAVI came into being. It is a minimally invasive procedure of replacing a damaged aortic valve. This procedure has proven to be a game changer as it brings down the risk factor to the minimum.
What is Transcatheter Aortic Valve Implantation (TAVI)?
As the word ‘transcatheter’ in the name suggests, this less invasive surgical procedure uses a specialized catheter (a thin, hollow tube) to replace the old, damaged valve. Unlike a conventional open heart surgery, TAVI does not require to surgically open the chest. TAVI procedure can be performed through small openings without causing any harm to chest bones or other organs.
Here are the major steps involved in the TAVI procedure:
- A specialist administers the local or general anesthesia, as per the surgeon’s instructions.
- Then the surgeon inserts a catheter into the artery through a small incision made either in the groin or under the collarbone. The catheter carries a balloon on its tip.
- Once the catheter reaches the damaged valve, the balloon is then gently inflated to make room for the new tissue valve, similar to stenting.
- The new valve now sits inside the damaged valve.
- The balloon is then deflated and the catheter is pulled out gently.
Benefits of TAVI over Surgical Aorta Valve Replacement
TAVI has proven to be a boon for high-risk heart patients.
Here are some major benefits of TAVI over conventional Surgical AVR:
- Minimal blood loss
- Safest possible procedure for people with a previous heart surgery
- Faster recovery (3-4 days of hospital stay)
- Better quality of life post-surgery
Who is the right candidate for TAVI?
Currently, this procedure is reserved for the people whose bodies are too weak to undergo an open heart surgery. Therefore, the majority of the patients who undergo TAVI are over 70 years. Apart from these aged patients, here are some other cases for which TAVI is the best alternative to the complicated surgical procedures:
- Patients who have had a heart surgery in the past
- Patients with coronary artery disease
- Patients with cerebrovascular and peripheral arterial disease
- Patients with a risk of kidney failure
- Patients with chronic respiratory disorders
- Patients with the severely calcified aorta
Risks associated with TAVI
Though several clinical trials all over the world have proven that TAVI is safe and effective, the procedure still carries some risks that everyone must be aware of.
- Valve leaks – In rare cases, if the new valve is not big enough to replace the old one, or could not fully expand, there could be some blood leak around the valve. However, it is completely avoidable with proper care and expertise, but important enough to be aware of.
- Harm to kidneys – The contrast dye which is used in the procedure for imaging can hurt the kidney. This problem is completely reversible, but again important enough to be discussed.
- Vessel damage – Passing catheters through the arteries can cause damage to them. This damage is mostly repairable.
- Increased risk of a stroke during or after the procedure.