What is the TAVI Method?

TAVI or Transcatheter Aortic Valve Implantation in medical terms, is the process of replacing a narrowed and incompletely opened aortic valve with a non-surgical closed method. The aortic valve is the structure between the left ventricle, which pumps blood to the body and the aorta, which carries this blood. Due to various diseases or aging, the valve may lose its elasticity and become narrow. This condition causes oxygen-rich clean blood not to be sent to the body in sufficient quantities, resulting in dysfunctions in vital organs and the heart itself. Heart failure, arrhythmia, stroke and sudden death are unfortunately highly probable outcomes that may occur if the disease is left untreated. With the TAVI method, this diseased and narrowed valve is made functional again by using special angiographic techniques and special bioprosthetic valves.

For which patients is the TAVI Method Recommended ?

Patients with severe narrowing of the aortic valve and associated symptoms and findings are candidates for TAVI. However, the TAVI decision for a patient is made by a team called the heart team which includes a cardiologist, cardiac surgeon and anesthesiologists. TAVI is the first choice in patients where open heart surgery, the traditional treatment for aortic stenosis, is not possible or carries a high risk. In addition, the procedure can also be performed in selected patients with medium or low risk for open surgery, based on the evaluation of the heart team.

How is the TAVI Method applied to the patient? How Long Does the Procedure Take? How Many Days Should the Patient Stay in the Hospital?

First of all, before the procedure, the patient is subjected to diagnostic procedures such as blood tests, echocardiography, computed tomography and coronary angiography, which will help both risk assessment and selection of the appropriate biological valve. The procedure is performed in the angiography laboratory, most often under general anesthesia or sedation. By the interventional cardiologist, a special catheter is placed in the groin artery, called the femoral artery, with an angiographic technique, and through this catheter, it is advanced from the groin artery to the area where the aortic valve is located. In patients whose inguinal artery is not suitable, the valve can be accessed from different arteries or regions. After the catheter reaches the aortic valve, the new valve is placed inside the old one, making the new valve functional with the appropriate opening. After the new bioprosthetic valve is left in place and fixed, the catheter is taken back out of the body through the groin vein. At the end of the procedure, the accessed inguinal artery is usually closed without surgery with a special closure device.
TAVI is a procedure that generally takes 1-3 hours, although the procedure time may vary for each patient. The patient is generally followed in the hospital for 2-3 days, with the first 24 hours in intensive care. If there are no problems during and after follow-up, the patient is usually discharged on the fourth day.

What are the advantages of the TAVI Method?

• Fewer Incisions
The most important advantage of TAVI is that it is a less invasive method than open surgery. In open surgeries, it is often necessary to make large incisions in the rib cage (bone and other tissues). Although the size of these incisions is reduced with minimally invasive surgical techniques, the risk is still higher than the closed method. TAVI is performed through only a small incision in the groin area, without the need to move any of your internal organs or ribs.
• Faster Recovery
Limiting the number and size of incisions also means your body has less to heal. This means less pain and easier healing process.
• Earlier Discharge
Patients who undergo TAVI are usually able to go home on the 2nd-3rd day.
• Return to Normal Activities in a Shorter Time
Patients who underwent TAVI can return to their normal activities in a very short time after discharge.

What are the Risks or Complications of the TAVI Method?

Although TAVI has many advantages, some complications may also occur. Although complications are rare thanks to the development of angiographic techniques and advances in new catheter-valve technology, the following complications may occur after TAVI;

• Bleeding in the groin artery area: May require blood transfusion or surgical repair to the groin area.
• Need for a pacemaker: A possible complication of TAVI is a disruption in your heart's electrical system. This may require the installation of a permanent pacemaker.
• Leakage around the new valve: Depending on the valve type, some people may develop paravalvular leakage. This means there is a leak at the outer edge of the new cap.
• Stroke
• Kidney Damage