What is a TAVI (Transcatheter Aortic Valve Implantation)?

A TAVI (transcatheter aortic valve implantation) is a catheter-based procedure to treat severe aortic stenosis (narrowing). It is a minimally invasive procedure that involves placing a new aortic valve without removing the diseased valve. Your doctor may recommend a TAVI if you are not able to undergo traditional open-heart surgery to replace your aortic valve. A TAVI can relieve symptoms of aortic stenosis and improve your quality of life.

Your aortic heart valve keeps blood flowing in one direction out of the heart and into the large blood vessel called the aorta. The aortic valve opens to allow blood to flow forward to the body and closes tightly so blood does not leak backwards into the heart. The aortic valve can become thick and stiff as you age, which narrows the valve’s opening. This condition, called aortic stenosis, prevents blood from flowing forward normally.

TAVI is an emerging technology that is only available at certain medical centers. A TAVI has serious risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having a TAVI. 

Why is a TAVI (Transcatheter Aortic Valve Implantation) performed? 

Your doctor may recommend a TAVI to treat symptomatic aortic stenosis if you are not a candidate for surgery. Your doctor may only consider a TAVI for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your treatment options before deciding on a TAVI.

Your doctor may recommend a TAVI under the following conditions: 

  • You have severe aortic valve stenosis and are experiencing symptoms, including chest pain, heart failure, fainting, and irregular heart rhythms (arrhythmias).
  • Medications have not improved your symptoms.
  • You are at high risk of poor surgical outcomes due to age, frailty, or other medical conditions.

Who performs a TAVI (Transcatheter Aortic Valve Implantation)?

Cardiac surgeons and interventional cardiologists work together to perform TAVIs. A cardiac surgeon specializes in the surgical treatment of conditions of the heart and its blood vessels. Cardiac surgeons may also be known as cardiothoracic surgeons. An interventional cardiologist specializes in diagnosing and treating conditions and diseases of the heart and blood vessels. They use nonsurgical, catheter-based procedures and specialized imaging techniques.

How is a TAVI (Transcatheter Aortic Valve Implantation) performed?

Your doctors will perform your TAVI in a hospital. Your doctor will make an incision in your groin and insert a catheter (a long, thin tube) through a blood vessel in your groin. Your doctor will guide the catheter up and into the heart until it reaches the diseased valve. The catheter tip contains a deflated replacement valve that your surgeon expands once the catheter is in place. 

Types of anesthesia 

Your surgeon will perform your TAVI using general anesthesia. General anesthesia is a combination of intravenous (IV) medications and gases that put you in a deep sleep. You are unaware of the procedure and do not feel any pain. 

What to expect the day of your TAVI (Transcatheter Aortic Valve Implantation)

Your surgeon may admit you to the hospital the day before your TAVI. The day of your procedure, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.
  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.
  • Talk with the anesthesiologist or nurse anesthetist about your medical history.
  • A surgical team member will start an IV.
  • The anesthesiologist or nurse anesthetist will start your anesthesia.
  • A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the procedure as they happen.
  • The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and during your recovery until you are alert, breathing effectively, and your vital signs are stable.