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Transcatheter Aortic Valve Implantation (TAVI)

Treatment Overview

Transcatheter aortic valve implantation (TAVI) is a procedure to implant a replacement aortic valve in the heart. It is also called transcatheter aortic valve replacement (TAVR). Your doctor will use a thin, flexible tube called a catheter to put in your new heart valve.

Your doctor will put the catheter into a blood vessel in your upper leg (groin) or chest. The doctor moves the catheter through the blood vessel and into your heart.

The replacement valve fits inside the catheter. The valve is made of tissue and metal. Your doctor will move the new valve into your damaged valve. It will expand and work in place of the old valve.

You may be asleep for the procedure, or you may get a sedative to help you relax. You won't feel pain when the catheter is put in the blood vessel.

You may stay in the hospital for up to a few days.

What To Expect

  • While you are in the hospital, your doctors and nurses will monitor you to check how the new valve is working.
  • You will receive information from the hospital about diet, activities, and medicine.
  • You will need to have regular checkups with your doctor.
  • Your doctor may suggest that you attend a cardiac rehab program. In cardiac rehab, a team of health professionals provides education and support to help you recover and prevent problems with your heart. Ask your doctor if rehab is right for you.
  • You may take aspirin or some other blood thinner to prevent blood clots. If you get a blood thinner, be sure you get instructions about how to take your medicine safely. Blood thinners can cause serious bleeding problems.

Why It Is Done

TAVI is done to treat narrowing (stenosis) of the aortic valve. This is the valve between your heart and the blood vessel (the aorta) that carries blood to your body. TAVI may also be done to place a new valve in an existing tissue replacement valve.

How Well It Works

This procedure can help people who have aortic stenosis feel better and live longer.

But how well this procedure works depends on several things, such as other health problems that a person has. These include other heart problems. Doctors are still learning who might benefit the most from TAVI.

Because TAVI is a newer treatment, doctors don't yet know the long-term benefits or risks. They also don't know how long the valves will last. But research shows that they work well for at least 5 years.footnote 1, footnote 2

Risks

TAVI doesn't involve open-heart surgery. But the procedure does have serious risks. Some risks last just a short time. Others are long-term.

Risks include:

  • Heart block. This is a problem with the electrical system in the heart. It can cause a slow heart rate. If this happens, a person may need a permanent pacemaker.
  • Injury to the blood vessel used to put the catheter in the heart.
  • Serious bleeding problems.
  • Leaking around the valve.
  • Heart attack.
  • Stroke.
  • Death.

References

Citations

  1. Kapadia SR, et al. (2015). 5-year outcomes of transcatheter aortic valve replacement compared with standard treatment for patients with inoperable aortic stenosis (PARTNER1): A randomised controlled trial. Lancet. Published online March 15, 2015. DOI: http://dx.doi.org/10.1016/S0140-6736(15)60290-2. Accessed March 25, 2015.
  2. Makkar RR, et al. (2020). Five-year outcomes of transcatheter or surgical aortic-valve replacement. New England Journal of Medicine, 382(9): 799–809. DOI: 10.1056/NEJMoa1910555. Accessed March 12, 2021.

Credits

Current as of: April 29, 2021

Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD - Internal Medicine
Martin J. Gabica MD - Family Medicine
Kathleen Romito MD - Family Medicine
Elizabeth T. Russo MD - Internal Medicine
Adam Husney MD - Family Medicine
John A. McPherson MD, FACC, FSCAI - Cardiology
Caroline S. Rhoads MD - Internal Medicine

 

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