TAVI: transaortic valve implantation
This intervention treats significant narrowing of the aortic valve. The transaortic valve is the valve that separates the left ventricle (the heart pump) from the rest of the circulatory system and allows blood to flow from the heart to the rest of the body. Implantation of an arterial valve through the groin crease is an alternative to “open heart” surgery.
Is the procedure painful?
This procedure is performed under local anesthesia with light “sedation” that will put you in a light sleep.
How the procedure is carried out
This first step involves puncturing the femoral artery and inserting a lead into the femoral vein that can electrically stimulate heart contractions. Next, the artificial valve is delivered to the heart by sliding it along a long, stiff, metallic rod. The new valve is then implanted directly at the site of the old one, obliterating it. The procedure is performed under X-ray guidance and with the help of iodinated contrast in the ascending aorta. Each injection is imaged by X-ray. Finally, at the end of the procedure, a closure system is put into place to “suture” the hole made in the femoral artery.
Is this an inpatient procedure?
This procedure involves a stay of several days. In general, discharge will occur after 2 or 3 days’ monitoring after the intervention.
Who is present for the procedure?
The following individuals are always present: the interventional cardiologist in charge of the procedure, a nurse who specializes in interventional cardiology, a nurse anesthetist and an anesthesiologist.
Are there any risks involved with the procedure?
Due to continuous improvement in materials in recent years, complications are becoming more rare. The potential risks associated with this procedure are: heart rhythm problems, vascular complications at the site of catheter insertion (bruising, perforation or arterial obstruction that may require surgical repair), myocardial infarction, embolization of valve material or clots, aortic dissection (tearing of the aortic wall), perforation of a heart chamber, cerebrovascular accident, renal insufficiency, endocarditis (infection of the valve), valve displacement, leaking around the valve, valve dysfunction, bleeding requiring transfusion, emergency bypass surgery or emergency aortic valve replacement surgery and death.