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TAVI – Transcatheter Aortic Valve Implantation-Minimally Invasive Aortic Valve Treatment
Minimally Invasive Valve Replacement for Aortic Stenosis
TAVI, or Transcatheter Aortic Valve Implantation (also known as TAVR, Transcatheter Aortic Valve Replacement), is a minimally invasive procedure used to replace a narrowed aortic valve in patients with severe aortic stenosis, particularly those at elevated surgical risk.
What Is Aortic Stenosis?
Aortic stenosis is a progressive condition where the aortic valve becomes calcified and narrowed, obstructing blood flow from the heart to the rest of the body. Left untreated, severe aortic stenosis leads to heart failure and death, with a poor prognosis once symptoms (e.g., syncope, chest pain, or dyspnea) appear.
What Is TAVI?
TAVI is a catheter-based procedure that allows physicians to replace the aortic valve without open-heart surgery. A collapsible bioprosthetic valve is delivered via a catheter—typically through the femoral artery—and deployed within the diseased native valve.
Key Advantages
✅ Minimally Invasive: No need for sternotomy or cardiopulmonary bypass
✅ Shorter Recovery Time: Patients often discharged within 1–3 days
✅ Option for High/Intermediate Surgical Risk Patients
✅ Now Approved for Low-Risk Patients (based on recent trials)
✅ Improves Survival, Function, and Quality of Life
Who Is a Candidate for TAVI?
TAVI is typically considered for patients with:
Severe symptomatic aortic stenosis, confirmed by echocardiography
High or intermediate surgical risk due to age, frailty, or comorbidities
Low-risk patients who prefer minimally invasive options (pending multidisciplinary evaluation)
Heart Team Evaluation (cardiologist + cardiothoracic surgeon) is essential to determine suitability.
Procedure Overview
Access: Commonly through the femoral artery (transfemoral), though alternative access routes (e.g., transapical, transaxillary) are available when needed.
Valve Deployment: The new valve is positioned inside the native aortic valve and expanded using a balloon or self-expanding mechanism.
Immediate Function: The new valve begins working immediately, pushing the old valve leaflets aside.
Monitoring: Post-procedure echocardiography confirms placement and function.
Post-TAVI Care and Follow-Up
Antiplatelet therapy or anticoagulation as per current guidelines
Monitoring for conduction abnormalities (e.g., need for pacemaker)
Regular follow-up echocardiograms and clinical assessments
Outcomes and Evidence
Recent randomized trials (e.g., PARTNER 3, Evolut Low Risk Trial) show that TAVI is non-inferior—and in some cases superior—to surgical aortic valve replacement (SAVR) in select low-risk patients, with faster recovery and similar long-term outcomes.
Common Considerations & Risks
Vascular complications
Paravalvular leak (minimized with newer valve generations)
Pacemaker requirement post-TAVI
Stroke (rare but serious)
Urgent calls
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