TAVI (Transcatheter aortic valve implantation)

What is a TAVI?

TAVI stands for Transcatherter Aortic Valve Implantation, a minimally invasive surgical procedure that repairs the damaged aortic valve without removing the native valve. An artificial valve partially made of natural animal heart tissue will be implanted into your heart.

The two types of TAVI valve preferred by our cardiologists are an ‘in balloon expandable’ and ‘self expanding’.

Patients with a higher risk of complications in traditional open-heart aortic valve replacement surgery are considered for TAVI. This procedure is performed on patients with symptomatic heart disease due to severe aortic stenosis. 

 TAVI procedure - A patient's journey

Why do I need a TAVI?

The aortic valve is one of four main valves in your heart. As your heart beats, the valve opens and closes, allowing blood to flow from your heart to the rest of your body in one direction.
As you age, calcium can build up on the aortic valve causing narrowing and degeneration. This can result in the valve not being able to function properly which means the heart has to work harder to pump blood through the narrowed valve. This condition is call aortic stenosis. Aortic stenosis is the most common primary cardiac valve disease leading to surgery or catheter intervention in western countries.

Patients with severe, symptomatic aortic stenosis have a poor prognosis without intervention; this mainly includes surgical aortic valve replacement or TAVI.

Pre-operative preparation

Patients are referred to the structural heart cardiologist by their existing cardiologist, GP or physician for TAVI assessment. All patients require extensive workup including seeing a cardiologist specialising in structural heart disease prior to proceeding to TAVI.

Appointments will be arranged for the patient to see both the cardiologist who specialises in TAVI along with Ashford Hospital’s dedicated TAVI co-ordinator, Sandra Ambrose.

If patients agree to the procedure and the risks involved they will require a coronary angiogram to rule out any coronary artery disease and assess the severity of aortic stenosis. CT assessment is also required to allow for calculation of the valve size and to formulate the most appropriate access plan.

It is mandatory that patients see a cardiothoracic surgeon and this will be arranged by the TAVI team. Further assessment by the multi-disciplinary team of specialists and healthcare professionals may be required depending on patients co-morbidities. Others involved with the TAVI program include vascular surgeons, anaesthetists, critical care specialists, general physicians, radiologists, technicians and expert nursing and allied health staff. Patients may be asked to visit their dentist prior to the procedure.

Following assessment and workup, cases are presented to the TAVI Multi-disciplinary Team for approval to proceed.

As with any surgery, there are risks involved and these will be explained in detail before the surgery. Patients are encouraged to discuss any questions or concerns with the TAVI team.

Pre-Admission Clinic

Patients are asked to attend a standard pre-admission clinic one week prior to the procedure during which routine investigations including bloods are arranged.

What to bring

  • Medicare card & any concession or private health fund cards
  • All medication currently being taken, in the original packaging
  • Night attire, including dressing gown and slippers (non-slip)
  • Toiletries

The Procedure

The procedure is performed at Ashford Hospital and patients are admitted the same day. TAVI is carried out under general anaesthetic in the hospital’s angiography suite which looks a little like an operating theatre. Currently TAVI’s are carried out on Tuesday afternoons.

  • An echocardiogram will be performed in the SA Heart Ashford clinic prior to your admission to the hospital
  • The cardiologist will perform an angiogram and a temporary pacing wire is inserted at this time.
  • TAVI is most commonly performed via the femoral artery or, if this is not possible, via the subclavian artery. Other options include access via the heart apex (transapical) or via the aorta following a small chest incision (transaortic).
  • A balloon catheter is inserted at the site
  • The balloon catheter is guided into your heart and carefully positioned within the opening of the aortic valve
  • The balloon is then gently inflated to open up the valve
  • The new aortic valve is positioned to push aside the damaged aortic valve and then implanted
  • The balloon is deflated and the catheter removed
TAVI procedure video

Post operative instructions

Patients are monitored closely following the procedure and will need to stay in hospital for 48 hours.

Two blood thinners will be prescribed post-operatively - Aspirin and Clopidogrel for six months and Aspirin lifelong thereafter.

Prior to discharge the TAVI co-ordinator will provide discharge instructions relevant to the patient’s situation.
Patients can contact us on 8297 6888 if they experience any signs or symptoms that cause concern.

Patients are unable to drive for four weeks as per the Austroads Guidelines. Other than this, patients can generally resume their normal lifestyle after discharge and any limitations will be explained prior to discharge. Patients will need to be accompanied by a responsible adult on discharge.

Follow up appointments are required with your TAVI cardiologist at one month with an echocardiogram, then again at six months and twelve months. After twelve months patients will be discharged back to the care of their usual cardiologist, GP or physician.

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