TAVI in India: transcatheter aortic valve implantation explained

What is TAVI?

The aortic valve controls blood flow from the heart into the aorta, the body’s main artery. In aortic stenosis the valve does not open fully. MedlinePlus notes this usually happens in older adults when calcium builds up on the valve.

In TAVI the cardiologist reaches the heart through an artery, usually in the groin or sometimes in the chest near the breastbone. A balloon is inflated in the old valve. A new biological valve is then placed inside it and takes over its work. MedlinePlus states that a heart-lung machine is not needed and that the procedure is usually done under moderate sedation, although a general anaesthetic may be used. Some patients need a pacemaker to keep the heart rhythm regular.

Who may be considered for TAVI?

MedlinePlus describes TAVI as a treatment for severe aortic stenosis in people who are not healthy enough for open chest surgery. It may be recommended when the narrowing causes chest pain, breathlessness, fainting or heart failure, or when tests show the valve is harming heart function.

Suitability depends on the shape and size of the valve and aorta, the arteries used for access and your overall health. Those questions need specialist imaging. Your heart team, usually a cardiologist and a cardiac surgeon, decides whether TAVI or surgical valve replacement suits you.

Which reports does a TAVI team usually ask for?

An echocardiogram showing the severity of the narrowing is the starting point. Detailed planning scans are often done at the treating hospital. When you send your case, ask whether the team needs:

• your latest echocardiogram report and images
• any CT scan of the heart and blood vessels already done
• a coronary angiogram, if you have had one
• a recent ECG, since rhythm problems affect the plan
• kidney function tests, because contrast dye is used
• a list of medicines, especially warfarin, clopidogrel or aspirin

How do I plan a TAVI trip?

Many TAVI patients are older and may have other conditions. Plan around their comfort. Stages usually include remote review, a written plan, visas for patient and attendant, arrival and planning scans, the procedure, a hospital stay and a period close to the hospital until the team agrees you can fly.

MedlinePlus lists practical steps before the procedure. These include seeing a dentist to rule out mouth infections, discussing any blood thinners with your cardiologist and reporting any recent cold, flu or fever. Arrange wheelchair help at both airports. An attendant who can manage paperwork and medicines makes the stay far easier. Ask the team to note in your discharge summary that you have a valve implant. You should mention it before any future medical or dental procedure.

What should I ask the hospital before booking?

• Has my heart team reviewed whether TAVI or surgery is more suitable for me?
• Which access route do you plan to use?
• Will I be sedated or under a general anaesthetic?
• How likely is it that I will need a pacemaker, and would it be fitted during the same stay?
• Which planning scans will be done after I arrive?
• Who will follow up my valve with echocardiograms after I return home?