The aortic valve usually opens when blood is pumped from your heart to the rest of your body. Aortic stenosis is a condition where the aortic valve cannot open and close properly. This condition puts extra strain on your heart and can result in breathlessness, swollen ankles, chest pain, dizziness, and sometimes, blackouts.
For people with aortic valve problems, the usual treatment is open heart valve surgery. However, for people who are too ill or who have many other medical problems, open heart surgery may be considered too risky.
Transcatheter aortic valve implantation (TAVI) is a procedure that allows an aortic valve to be implanted using a long narrow tube called a catheter. Usually, the catheter is inserted into a large blood vessel in your groin or through a small incision in your chest.
Transcatheter aortic valves are specially designed for this procedure. The valve is made of natural tissue from the heart of either a cow or a pig. The natural tissue is re-engineered and attached to a flexible expanding mesh frame. In order to implant it into the heart, the valve is squeezed around or inside a catheter. The catheter is then inserted and guided to the aortic valve opening in your heart where it is implanted over your existing valve. Once the new valve is implanted, the catheter is removed. The new valve starts working right away.
To determine whether or not you would benefit from a TAVI procedure, expect your doctor to order several tests including an electrocardiogram, echocardiogram, computed tomography (CT) scan, and angiogram.
Additionally, expect to be contacted by the TAVI coordinator before your procedure is booked. The TAVI coordinator will work with you and your family to plan your procedure and to ensure that you know what to expect throughout the waiting period.
Once the procedure is booked, expect the following:
- You will be admitted to the Heart Institute on the day before the procedure.
- You will be asked to sign a consent form.
- On the day of your procedure, you will be taken to the Cardiac Catheterization lab.
- You will receive general anaesthesia so you will sleep through the procedure and not feel any pain.
- Your procedure will be performed by a specialized team that includes an interventional cardiologist, a cardiac surgeon, and a cardiac anaesthetist who specializes in cardiac ultrasound imaging.
- Using the specialized ultrasound and X-ray imaging, the doctor will guide the catheter with the valve up to the aortic valve in your heart.
- Once it is correctly positioned, the new valve will be implanted over the current valve.
- The catheter is then removed and the new valve begins to work immediately.
After the procedure, you will be monitored in the Surgical Intensive Care Unit for at least 24 hours. Once you are stable, you can be moved to a regular ward and, over the next five to ten days, you will recover and prepare for your discharge.
Ensure that you bring all your medications (including non-prescription medications and any supplements) with you when you come to the hospital.
If you have any of your own teeth, make sure that you have seen a dentist within the last six months before your TAVI procedure is booked.
Patients with valve replacements may have an increased risk of developing infection of the heart valve and surrounding tissue called endocarditis. Check with your doctor, you may need anti-biotics before some surgical procedures or dental visits.
For more information, see the TAVI Patient Guide.