Transcatheter Aortic Valve Implantation (TAVI):  TAVI surgery is the most effective treatment for aortic stenosis. The surgery involves the replacement of the affected valve with an artificial valve made of natural animal heart tissue (usually from a cow or a pig). However, the artificial valve is more successful than a biological tissue valve which has a tendency of relapsing with time. The procedure is less invasive and is done by making a small incision on the patient’s leg or chest via which the catheter is inserted into the body and then lead towards the affected valve with the help of precise image guidance. 

Aortic Valve Stenosis: It is a very serious heart condition which may or may not be congenital. In this condition, the aortic valve narrows down restricting the blood flow from the left ventricle to the aorta. This results in an unanticipated pressure build-up in the left atrium. 
 

Any heart problem begins with sudden or gradual uneasiness and your body starts giving you signals that something is wrong. Generally, we ignore the mild signs and start to take these seriously only when they progress or become persistent. Aortic valve stenosis, sometimes, might not show any symptom and only tests and scans can detect the problem. Some of the common symptoms associated with Aortic Valve Stenosis are as under:

• Chest pain
• Murmuring sound while you breathe
• Palpitations
• Fainting
• Breathlessness

Children with a congenital Aortic Valve Stenosis may experience:

• Breathing irregularities
• Slow or no weight gain
• Insufficient feeding

Some of the major conditions that we with a treat with Transcatheter Aortic Valve Implantation (TAVI) are listed below:

• Wearing of the aortic valve in the elderly people
• The scarring of the aortic valve due to rheumatic fever 
• The congenitally bicuspid aortic valve

A doctor will evaluate you for various conditions before advising you to undergo TAVI. These conditions include:

• Old age
• Weak heart muscles
• Previous heart surgery
• History of stroke
• Chronic Obstructive Lung Disease (COPD)
• Previous radiation treatment to your chest
• Birth related heart conditions (congenital heart disease) such as a bicuspid aortic valve
• History of a heart affecting infection
• Having cardiovascular risk factors, such as 
  • Diabetes
  • High cholesterol 
  • High blood pressure
• Chronic kidney disease
• Porcelain aorta - Large calcium deposits in ascending aorta (the blood vessel that carries blood away from your heart)

The doctors may conduct several diagnostic tests and screenings like:

• ECG
• Echocardiogram
• Cardiac MRI
• Cardiac Catheterisation
• CT Scan
• Chest X-ray
• Exercise test 

According to the diagnostic test results, the doctor will identify whether a patient needs to undergo TAVI or not.

TAVI procedure is used to treat most complex Aortic Stenosisconditions. This procedure is either performed on children or people who are not eligible for the other surgical procedures. The various steps involved in theTAVI procedure are as under:

Before the procedure

A doctor evaluates the patient for possible complications that may arise during the TAVI procedure. A doctor might prescribe some medication to reduce the risk prior to the procedure.

During the procedure

• STEP 1: The area of the body where TAVI has to be performed is numbed using a general anaesthetics.
• STEP 2: Balloon valvuloplasty is performed using a catheter (hollow tube) with a balloon attached to one of its tips. This catheter is inserted into an artery either via the groin or by making a keyhole incision on the side of the arm, leg or chest.
• STEP 3:The catheter is then directed towards the patient’s heart and positioned at the opening of the aortic valve.
• STEP 4:In this step, the balloon attached to the catheter is gently inflated with an aim to make room for the placement of new tissue valve.
• STEP 5: The new tissue valve is placed in position and expanded using a balloon. 
• STEP 6: The balloon is then deflated removed along with the catheter.

Finally, a new valve has replaced the damaged valve.

After the Procedure

The patient has to spend a day or two in the intensive care unit for monitoring purpose. However, the overall recovery time is around 12 weeks. After surgery, most people remain asymptomatic and start to feel better. However, they have to take blood-thinning medications for a lifetime to prevent blood clots formation. 

With TAVI procedure the patients start to feel better right away. It has major benefits such as:

• The patient feels more energetic
• The patient is able to do everyday activities
• The patient is able to Breathe normally
• Patient experience less pain
• The patient feels less anxious

Some of the major precautionary measures a patient must take after the TAVI procedure are:

• Be punctual with the medication
• Maintain a healthy lifestyle
• Exercise daily 
• Keep your sugar in check
• Don’t take stress or live/work in a stressful environment 
• Keep your blood pressure in check 
• Keep a tab on your cholesterol 
• Maintain your BMI

BLK Super Speciality Hospital has a high success rate in performing Transcatheter Aortic Valve Implantation (TAVI). However, some risk factors may arise depending on the condition of a patient. Possible complications after the procedure include:

Very Common Complications

• Damage to your blood vessels
• Bleeding
• Blood Clot
• Collection of fluid around your heart
• Decreased blood supply to your brain

Rare Complications

• Heart attack
• Kidney failure
• Lung puncture
• Failure of your replacement valve
• Severe heart failure
• Death (in rare cases)

A patient must seek immediate medical help if the complications do not improve.