Transcatheter aortic valve replacement/ implantation (TAVR/ TAVI) is a minimally invasive treatment option for severe aortic valve stenosis (severe AS).
In our team of healthcare professionals are specialists involved in one of the first TAVR procedures in Asia as well as one of the proctors for a global TAVR programme.
The aortic valve in the heart allows blood to be pumped out to the rest of the body. With ageing, the aortic valve may become narrowed. In severe AS, the valve narrowing becomes severe and patients usually develop breathlessness, fainting spells and chest discomfort. Left untreated, up to 50% of patients may die from the condition within 2 years.
Open heart surgery to replace the aortic valve is conventionally used to treat severe AS. However, the surgical risks are often high for many elderly patients and those suffering from debilitating diseases, like poor heart function, severe lung disease and end stage renal failure. Some patients are even considered inoperable.
TAVR/TAVI is now an alternative treatment option for elderly patients suffering from severe AS. This minimally invasive method is usually performed via a small puncture in the groin and occasionally, via a small cut in the side or front of the chest. A guiding catheter, a thin and flexible tube, is used to implant an aortic valve onto a beating heart.
Unlike open heart surgery to replace the aortic valve, with TAVR/TAVI, the patient's chest is not cut open and the heart is not stopped. The procedure can also be done under local anaesthesia.
Step 1: Balloon Valvuloplasty
Guided by a catheter, an inflatable balloon is first inserted into the aorta to open up the heart valve.
Step 2: Aortic Arch Navigation
The transcatheter heart valve is navigated through the artery into the heart.
Step 3: Native Valve Crossing
The artificial valve is placed in position in preparation for deployment.
Step 4: Deployment
The inflatable balloon is used to deploy and lock the valve in place. There are also other TAVR/TAVI valves that are self-expanding and do not require a balloon for deployment.
Step 5: Final Assessment
The catheter is removed and the new valve is now functioning in place of the original diseased valve.
TAVR/TAVI may be an option for people who have severe AS and at increased risk for surgery, or who are not suitable for open heart surgery. The procedure aims to alleviate the symptoms associated with AS and improve life span.
Following the procedure, you may have to spend 3 to 5 days recovering in the hospital, which may include a period of observation at the intensive care unit, before you can be discharged.
There are potential risks for the TAVR/TAVI procedure, including:
- Risk of bleeding
- Heart attack
- Abnormalities in heart rhythms
Our specialists will be able to provide advice on your suitability for TAVR/TAVI and answer your questions about the procedure.