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Transcatheter Aortic Valve Implantation (TAVI) offers hope for formerly inoperable patients.
Medically Reviewed by Michael Carmichael, MD
Want to have something in common with TV personality Barbara Walters? She had a TAVI.The most common heart valve problem is a narrowing of the aortic valve – the gateway for blood leaving the heart for the rest of the body. Aortic stenosis reduces the amount of oxygenated blood that reaches organs.
While the number of aortic valve stenosis cases are increasing, they are mostly found among the elderly or people with diabetes. As many as 20% of these patients have other medical problems that rule them out for a traditional valve surgery, where the specialist open the chest to get to the heart.
The new TAVI -- also called TAVR (Transcatheter Aortic Valve Repair) -- opens the possibility for these high-risk patients to regain heart health and improve their quality of life.
A cardiac surgeon makes a small incision in the chest or groin area. A thin tube (catheter) is inserted and fed into position near the faulty aortic valve. A balloon expands. The artificial valve unfolds, pushing the faulty valve out of the way. The balloon is deflated and the catheter removed.
“Since no bones are divided, as in regular valve surgery, recovery is faster,” says McLeod Cardiothoracic Surgeon Dr. Michael Carmichael. “Heart valve patients in Europe have been receiving the procedure since 2007. However, the more extended approval process in the US has delayed the TAVI’s introduction until more recently.”
Even in Europe, the procedure is so new there is no evidence of long-term results. Nevertheless, short-term results seem promising. One study showed that in the first year following surgery, TAVI patients survived better than traditional valve replacement patients. After two years, the survival rate for TAVI was the same as traditional valve surgery. A European study included a 3-year follow-up and concluded that non-cardiac causes were the cause of the majority of deaths in TAVI patients. In other words, they died from some other health issue – not failure of the TAVI.
Who is most suitable for the TAVI?
At this point, the TAVI is used for elderly, diabetics (who may have renal problems resulting from traditional surgery) and other patients considered too high-risk due to their medical condition. When long-term results are available, TAVI may become more widely used.
If you have questions, contact your cardiologist or cardiac surgeon, who will be aware of the latest information and developments on the subject.
Sources include: McLeod Health, National Institutes of Health, Annals of Cardiothoracic Surgery, Society of Cardiovascular Angiography & Interventions, American Heart Association, British Heart Foundation, US Food & Drug Administration.