What is it
This is a minimally invasive procedure performed in patients with aortic stenosis (narrowing) by a team of cardiologist and cardiac surgeons. It involves wedging a new valve over the old one without having the need to open the anterior chest (sternotomy). A flexible tube (catheter) is threaded up to the heart and across the aortic valve.
Expanding the new valve, which is mounted on a big wire mesh tube, pushes the old valve leafl ets out of the way and the tissue in the replacement valve takes over the job of regulating blood flow (Fig. 10). Two diff erent approaches are possible, allowing the team to select the most safe and effi cient for each specifi c patient. The first and more common is via the femoral artery (large artery in the groin).
This is called the “transfemoral approach” and does not require any surgical incision in the chest. For patients with extensive sickness in the big artery, which does not allows placement of big catheters, a minimally invasive surgical approach with a small incision in the chest is an alternative option (“transapical approach). Patients are usually discharged 2-4 days after the operation.
Why a patient needs a TAVI
Aortic stenosis describes a narrowing of the exit of the left ventricle (the main heart chamber). This prevents blood to be properly pushed forward in the body. Diffi culty to exercise, shortness of breath and sudden loss of consciousness are usually present, and progressive failure of the main chamber to pump blood forward or sudden cardiac death are common if the sickness is not treated. Therefore, patients with a severe narrowing of the aortic valve will benefit from a valve replacement. In the past, patients with advanced age or additional health problems did not qualify for “standard” cardiac surgery because the risk of opening the chest and directly work on the heart and valve was too high. Due to its lower general risk, TAVI (Transcatheter
Aortic Valve Implantation), also called TAVR (Transcatheter Aortic Valve Replacement), nowadays can be performed in patients
at high or middle risk for a “standard” cardiac surgery operation.
What we perform
TAVI/R is performed by a team of cardiologist and cardiac surgeons working together in a combined environment (hybrid operational room). This approach increases effi cacy and safety, because the procedure can be safely switched from minimally invasive to standard cardiac surgery, if needed. Several diff erent TAVI valves are available, and the selection will be made according to the specific patient needs and operator preferences.