TAVI stands for transcatheter aortic valve implantation. The aortic valve opens to let blood leave the heart and enter the aorta, the main artery supplying the body. If the valve becomes stiff and narrowed, the heart has to work harder to push blood through it. This narrowing is called aortic stenosis.
TAVI places a replacement valve inside the existing valve, which is left where it is. The new valve is a metal frame holding tissue leaflets that open and close. As the frame expands, it pushes the old valve leaflets aside, and the new valve then controls blood flow.
The aim is to help blood flow out of the heart more freely, although other heart conditions may still need treatment after TAVI.
Call triple zero (000) for severe, worsening or persistent chest pain, or chest discomfort with breathlessness, sweating, nausea or pain spreading to your arm, jaw or back.
Do not wait for a routine appointment or drive yourself to hospital.
The hospital gives you instructions about eating, drinking and medicines. Make sure staff know about blood thinners, diabetes medicines and any previous reaction to an anaesthetic or contrast dye. Don't change medicines without those instructions.
You'll lie on a procedure table with monitors checking your heartbeat and blood pressure. Local anaesthetic numbs the groin if that route is used. You may have sedation to make you relaxed and drowsy, or a general anaesthetic so you're asleep. The anaesthetist discusses this with you beforehand.
The doctor usually makes a small opening in an artery at the top of the leg. A catheter, a thin flexible tube, carries the folded replacement valve through the artery and along the aorta to the narrowed valve at the heart's outlet. If that route isn't suitable, the team plans another approach.
X-ray images help the doctor position the folded valve inside your existing valve, and a temporary pacing wire may be used to control the heart rate while it's being positioned. Some valve frames expand when released from the catheter; others are opened by inflating a balloon. The expanded frame holds the new valve in place.
The doctor uses imaging to check the new valve's position and how well blood flows through it. The delivery catheter and any balloon are then removed and the opening in the artery is closed, leaving the replacement valve in your heart.
TAVI is a treatment option for severe aortic stenosis. Symptoms can include breathlessness, chest discomfort, feeling faint or being unable to do as much as before. Over time, severe narrowing can put increasing strain on the heart. Whether the valve needs replacing depends on both your symptoms and the heart scan findings.
A hospital team, including cardiologists and a heart surgeon, weighs TAVI against valve surgery and care without a procedure. They look at the size and shape of your valve and blood vessels, how well you're likely to recover from an operation and how much of your difficulty is caused by the narrowed valve.
An echocardiogram, or heart ultrasound, shows how narrowed the valve is and how the heart is pumping. A CT scan measures the valve and surrounding structures and shows the blood vessels, so the team can choose a valve size and a route to the heart. Some people also need a coronary angiogram to check the arteries supplying the heart.
After TAVI, you'll rest in a recovery area while staff check your heart rhythm, blood pressure and catheter entry site for bleeding. You may need to lie flat at first so the artery opening can seal. How long you stay in hospital depends on how you recover and whether any problems need treatment.
Before leaving, you'll receive instructions about wound care, medicines, activity and when you can drive. Plan for help at home if needed. Cardiac rehabilitation can help you return to activity with guidance from health professionals.
Follow-up appointments and echocardiograms check how the new valve is working. Take prescribed medicines that prevent blood clots as directed, and speak with the treating cardiologist before stopping them. Tell your dentist about the replacement valve, because some dental procedures require antibiotics to reduce the risk of valve infection.
Contact the hospital or a doctor promptly about fever, worsening wound pain, redness or swelling. Follow the discharge instructions for bleeding or other urgent problems.
Replacing a severely narrowed valve can improve blood flow and ease symptoms such as breathlessness during activity. It doesn't treat other causes of breathlessness, such as lung disease, so you may still have symptoms after TAVI.
Bruising or bleeding where the catheter enters the artery can occur. More serious risks include injury to a blood vessel, stroke, kidney problems and leakage around the new valve. Rarely, a complication can be life-threatening. TAVI can also affect the heart's electrical signals, and some people then need a permanent pacemaker. The hospital specialist explains your individual risks before you decide.
Surgical valve replacement removes the damaged valve before fitting a new one. It usually involves opening the chest to reach the heart, whereas TAVI through the groin avoids a chest incision. Surgery can be an alternative when TAVI isn't suitable.
Medicines may help symptoms or other heart conditions, but they don't reverse the narrowing of a stiff aortic valve. If the risks of valve replacement outweigh the likely benefit, care can focus on controlling symptoms. The decision also needs to reflect your wishes and the activities that matter to you.
A valid referral from your GP or specialist is needed for a Heartscope cardiologist appointment. The cardiologist can review your symptoms and valve test results, discuss treatment options and refer you to a hospital valve team if needed. The clinic can answer questions about the consultation.
Consultations are privately billed. If you're eligible, Medicare pays part of the consultation fee when you have a valid referral from your GP or specialist. The clinic will confirm the amount left to pay before the visit.
TAVI and hospital care aren't included in the Heartscope consultation fee. The hospital and treating providers confirm their own fees separately.
Heartscope cardiologists see patients at clinics in Melbourne and Queensland. If you have a referral, our team can confirm the location and appointment details.
View clinic locationsNo. It's performed in hospital. Heartscope cardiologists may be able to see patients with a valid referral from their GP or specialist, and can refer you to a hospital valve specialist when appropriate.
Yes. TAVR means transcatheter aortic valve replacement. Both names describe placing a replacement aortic valve through a catheter.
With sedation, you may be aware of your surroundings and remember some of what happens. With a general anaesthetic, you're asleep. The anaesthetist discusses which approach is suitable for you before the procedure.
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