Transcatheter Aortic Valve Replacement / Implantation (TAVR / TAVI)

TAVR is an efficient procedure used to manage the following conditions:

• Aortic valve stenosis: TAVR alleviates the symptoms of aortic valve stenosis, such as chest pain, fainting, fatigue, shortness of breath, swelling in the legs, and in severe cases, heart failure.
• Non-functioning biological tissue replacement valve: TAVR is useful for people who have an existing biological tissue replacement valve that is not functioning well anymore.

TAVR involves replacing your damaged aortic valve or your poorly functioning existing replacement valve with one made from cow or pig heart tissue, also called a biological tissue valve. 

TAVR procedure:

• The procedure is performed in an operating room by a specialised heart team.
• Before the TAVR procedure, you may be administered general anaesthesia.
• Medication will be given to you intravenously to avoid the formation of blood clots.
• Your heart function and rhythm will be monitored continuously by the TAVR team.
• For the TAVR procedure, doctors usually insert a thin tube (catheter) through a blood vessel in your leg. Access can also be provided through the chest, which permits the doctors to reach the heart via a large artery or the bottom left chamber of the heart.
• Using advanced imaging techniques, the catheter is guided along your blood vessels, into the heart, and to the aortic valve.
• Once the catheter is positioned precisely, your doctor will expand a balloon to press the replacement valve into place inside the native aortic valve. Some valves can be expanded without a balloon.
• Once the valve is securely in place, the catheter is removed from your body.

The TAVR procedure typically takes a few hours, but this may vary depending on the individual.

• Before TAVR, you will be evaluated by a multidisciplinary team of medical and surgical heart valve specialists to determine if you are suitable to undergo the treatment.
• You will undergo an evaluation including blood tests, imaging scans, and heart function tests to ensure there are no risk factors that may impact you during the procedure.
• You may also be prescribed medications to decrease infection risk prior to the procedure.

As with any heart procedure, TAVR carries a risk of complications, which may include:

• Bleeding
• Problems with the replacement valve (valve slipping out of place or leaking)
• Stroke
• Heart rhythm abnormalities (arrhythmias)
• Kidney disease
• Infection
• Death

• You may be required to stay in the intensive care unit (ICU) for a night after your TAVR procedure; usually, a hospital stay for 2–5 days is required for recovery.
• Your doctor will prescribe blood-thinning medications to prevent the formation of blood clots and also discuss the duration of these medications.
• You may need to continue taking certain medications after your procedure.
• Your doctor will recommend medications before certain dental procedures to lower the risk of heart infections.
• It is important that you take your medications as prescribed.
• Regular follow-up appointments with your doctor are essential to monitor valve function and overall health.
• Let your doctor know if you have any new or worsening signs or symptoms. Your doctor may recommend healthy lifestyle changes, such as eating a heart-healthy diet, exercising regularly, maintaining a healthy weight, and avoiding drinking and smoking.