TAVI…The (Less Invasive) New Kid on the Block
If your Aortic Valve is no longer working the way it is supposed to, you may need to have it replaced. The Aortic Valve is the one-way valve between the Left Ventricle, which is the largest pumping chamber of the heart, and the Aorta, which is the “stump” of the vascular “tree” that delivers oxygen every cell in our entire body so that they can have the fuel they need to do their jobs. The most common way that the Aortic Valve starts to “wear out” is called stenosis. This means that the leaflets of the valve become stiff and hardened, usually with calcium and they no longer open very well. This can decrease the amount of blood that gets pushed out to our bodies and make our hearts to work harder.
Traditionally, when Aortic Stenosis becomes severe, it is time for the heart surgeons to open our chest, stop our hearts, take out our worn out valve and sew in a new valve. This is called Surgical Aortic Valve Replacement or SAVR for short.
However, since 2002, there has been an alternative to SAVR. This procedure is called Transcatheter Aortic Valve Implantation or Replacement (TAVI or TAVR). As with any new procedure, it is unknown whether the procedure will work or whether the results will last for any length of time. Well, it is now 2019 and we are doing more TAVI’s than ever.
For a TAVI, the new aortic valve is delivered through a catheter or tube. This is usually done through the artery in our groin. The new valve travels up the aorta to our worn out aortic valve. The valve is then deployed. This means it is opened up inside of the old, worn out valve. Basically the new valve pushes the old valve out of the way and begins working immediately. The patient is usually awake (but sedated), the chest is not opened up and the heart is never stopped which is less invasive and makes for a quicker recovery. Often patients are discharged home one or two days after the procedure.
Of course there are some risks, the most common being bleeding, having a stroke or needing a permanent pacemaker after the procedure. Currently this is a procedure that is most commonly done for patients who are not candidates for the traditional open heart procedure because their risks are too high. However, as time goes on, the trend suggests that patients who are lower risk for open heart surgery may end up getting TAVI instead.
We have been doing TAVI’s in Kelowna General Hospital since September of 2018 and will probably do about 50 of them in 2020. This is great news for the people of BC’s Interior because they will no longer have to travel to Vancouver if they are a candidate for TAVI…The (Less Invasive) New Kid on the Block.