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TAVI & TAVR

Dr. Dhiren Shah guides you through the complete process of TAVI and TAVR with a complete understanding of the process and videos from some of his best TAVI & TAVR cases in India. 

CIMS Hospital is known as the best TAVI & TAVR hospital led by Dr. Dhiren Shah – amongst the best TAVI & TAVR surgeons in Ahmedabad and recognised amongst the top TAVI & TAVR doctors in India.

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Who needs TAVI & TAVR ?

  • TAVI/ TAVR is a minimal invasive procedure hence, one can avoid the risk of open heart surgery.
  • TAVI/ TAVR is needed in case of severe aortic stenosis (narrowing of the arterial valve).
  • The complications of major surgeries (open heart surgery) such as blood loss or wound infection is minimized.

What is TAVI & TAVR?

TAVR is an abbreviation for Transcatheter Aortic Valve Replacement and TAVI is an abbreviation for Transcatheter Aortic Valve Implantation. TAVR/ TAVI is the procedure used to replace the narrowed aortic valve with an implant.

How do you diagnose the need for TAVI & TAVR ?

The need for TAVR/TAVI can be diagnosed using:

  • Cardiac catheterization
    • Checks the functioning of heart
  • CT scan
    • CT scan gives proper image of the heart and it’s functioning
  • Frailty test
    • Done to check the physical fitness of elderly patients
  • Echocardiogram
    • Assesses the functioning of the heart
  • Blood test
    • Done to check presence of any disease or infection

TAVI & TAVR

What are the common indications for TAVI or TAVR ?

  • Patients who are indicated for TAVR/ TAVI are as follows:

    • Severe aortic stenosis (aortic valve becomes narrowed due to the deposition of calcium)
  • Patient at high surgical risk
  • Left Ventricular Ejection Fraction (LVEF) less than 50%
  • Patient who have already gone for cardiac surgery
  • Patient above 75 years of age, presence of multiple comorbidity (one condition is often accompanied by another)

What are the contradictions for TAVI & TAVR ?

  • Patients who cannot undergo TAVR/ TAVI are as follows:

    • Myocardial infarction (diagnosed within 30 days of TAVR/ TAVI)
    • Aortic disease
    • End stage renal problems
    • Life expectancy less than 12 months
    • Presence of thrombus
    • Severe mitral regurgitation
    • Congenital valve disease

What are the approaches to TAVI or TAVR ?

There are two approaches that a cardiologist uses to perform TAVR/ TAVI. They are:

  1. Transfemoral (most commonly used, incision is made in the leg to access the femoral artery)
  2. Transapical (small incision is made on the chest wall)

What are the risks attached to TAVI and TAVR?

Risks associated in TAVR/ TAVI procedure are:

  • Stroke
  • Heart attack
  • Bleeding
  • Damage to vessels
  • Infections
  • Abnormal heart rhythm
  • Infections
  • Death

HEART FAILURE

What is the procedure of TAVI or TAVR ?

  • The procedure of TAVR/ TAVI takes 2-3 days for discharge. Recovery is faster. Patient can resume to standing and walking in a day or two.

    The procedure for TAVI/TAVR are as follows::

    Admission of the patient

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    Signing of the consent form

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    Preparation of the patient

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    Choice of anesthesia

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    Choosing the best approach

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    Passing the catheter with valve to the aortic valve

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    The valve is placed at damaged aortic valve

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    Catheter is then removed

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    Monitoring of the patient

What are the advantages of TAVI or TAVR ?

  • The advantages of TAVR/ TAVI are as follows:
    • Symptoms of aortic stenosis is relieved
    • Chances of survival are high
    • No marked breathing difficulties
    • Less invasive
    • Less painful
    • Recovery time is faster

How is after treatment care taken for TAVI or TAVR patients ?

  • The following care should be followed after a TAVR/TAVI:

    • Regular intake of medicines as prescribed
    • Restriction in activities, if needed
    • Intake of antibiotics, if at risk of infection
    • Regular check ups

When should I avoid TAVI or TAVR ?

  • In the following cases the TAVI/ TAVR should be avoided:

    • Patients with a history of infections
    • Patients in whom blood thinning medications are contra-indicated.
    • Patients whose body react to some metals
    • Patients who have already gone through a valve replacement surgery and have a mechanical valve

What may be other complications of TAVI or TAVR ?

  • Some other complications that might be associated in few cases of TAVI/ TAVR are:

    • Leakage through or around the valve
    • Thrombus(blood clot) formation 
    • Pain
    • Nerve damage
    • Narrowing of the valve (stenosis)
    • Hyper-/ hypo-tension
    • Cardiogenic shock (heart fails to pump blood)

What is the survival rate in TAVI or TAVR ?

  • As stated by NCBI: the aggregated survival rate at 1-, 2-, 3-, 5-, and 7-years after TAVR/TAVI were 83%, 75%, 65%, 48%, and 28%, respectively.
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