Transcatheter Aortic Valve Implantation (TAVI)

There is now a new development in the treatment of aortic stenosis.  Transcatheter Aortic Valve Implantation (TAVI) is a new way to implant an artificial aortic valve inside the patient’s own aortic valve without having to go on the heart-lung machine or cardiopulmonary bypass. 

Transapical incision

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Currently it is only performed on patients that are too sick for standard aortic valve replacement, and it is only for aortic valves with aortic stenosis.  So far, results with this procedure have not been as good as for standard aortic valve replacement surgery, but it may be the only option for some patients.

This still requires general anesthesia and some form of incision.  There are two ways to do this. 

One is called Transapical, and this requires a small incision in the left side of the chest.  The tip, or “apex” of the heart is exposed. 

An artificial heart valve is compressed and placed on a catheter, which is passed through the apex and out across the patient’s own aortic valve.  A balloon is then used to expand the artificial valve into position.

Transfemoral incision

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The other way to do this is called Transfemoral,  and this requires an incision in the groin where the femoral artery is exposed. 

The catheter is passed back up the femoral artery into the aorta, and around to and through the patient’s own aortic valve. 

Once in place, a balloon is used to expand the artificial valve into position.

 

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