Transcatheter Aortic Valve Replacement is a surgical procedure in which smaller incisions are made to replace the damaged aortic valve with an artificial valve. The aortic valve is present in the heart and controls the blood flow from the heart to the body. It is also known as transcatheter aortic valve replacement or TAVR. A transcatheter aortic valve implantation surgery is done in patients where blood circulation from the heart to the body is severely compromised. When it is impossible to treat aortic valve dysfunction with medications and other treatments, then it is replaced by artificial implants in the procedure of transcatheter aortic valve implantation. TAVI is usually performed on patients where open heart surgery is too dangerous for the patient and the patient has other deadly diseases that are difficult to manage in open heart surgery. TAVI also has the advantage of shorter hospital stays after surgery and fewer complications than open heart surgery. It also requires less time for recovery. Transcatheter aortic valve implantation also has some risk factors that should be managed to prevent the delay in the recovery process. TAVI surgery improves the symptoms in patients and also improves the quality of life of patients.
Types of Transcatheter Heart Valve Procedures
Compare TAVI, balloon valvuloplasty, and minimally invasive aortic valve replacement options.
Types of Transcatheter Aortic Valve Implantation Treatment India
Here are the types of Transcatheter Aortic Valve Implantation (TAVI):
- Transfemoral TAVI
- Transapical TAVI
- Transaortic TAVI
- Transcaval TAVI
- Trans-subclavian TAVI
- Direct Aortic TAVI
Transfemoral TAVI
In this approach, the new aortic valve is inserted through a catheter from the femoral artery in the groin. It is the most common and preferred method when feasible due to its less invasive nature.
Transapical TAVI
This approach involves inserting the new valve through a small incision in the chest, usually on the left side between the ribs. The catheter is guided directly through the upper part of the heart. This method might be chosen if the femoral approach is not suitable.
Transaortic TAVI
In this type of TAVI, the new valve is delivered through a small incision in the aortic arch. This approach might be used when the femoral or transapical methods are not ideal.
Transcaval TAVI
This newer approach involves creating a temporary connection between the abdominal aorta and the inferior vena cava, allowing the catheter to deliver the valve through the abdomen. It is used in some cases when other methods are not suitable.
Trans-subclavian TAVI
In this approach, the catheter is inserted through a small incision in the artery which is located below the collarbone to access the aortic valve. This method is used when other methods cannot be used.
Direct Aortic TAVI
In this type of TAVI, the new valve is placed directly into the aorta through a small incision made in the wall of the aorta. This approach is only performed when the overall health of a patient is good.
Procedure of TAVI
Here is the general view of the procedure of transcatheter aortic valve replacement:
- Anesthesia: The procedure is usually performed under local anesthesia to decrease the feeling of pain and discomfort during the procedure.
- Access: The chosen access point is cleaned and a small incision is made to insert the catheter.
- Catheter Insertion: A catheter with a compressed new valve is inserted through the access point. The catheter is guided through the blood vessels toward the aortic valve.
- Positioning: Using advanced imaging techniques, the catheter is carefully positioned at the site of the diseased aortic valve.
- Valve Deployment: Once the catheter is properly positioned, the new valve is deployed. In the case of a balloon-expandable valve, a balloon is inflated, expanding the new valve and pushing aside the diseased valve leaflets. The self-expanding valve naturally expands as it's released from the catheter.
- Removal of Catheter: The catheter is removed, and the access site is typically closed by using sutures.
- Recovery: Unlike open heart surgery, TAVI requires less time for recovery and a shorter stay at the hospital after the surgery.
Cost of TAVI or TAVR in India
The cost of transcatheter aortic valve replacement in India ranges from 5909 USD to 8030 USD. However, it can vary according to the type of procedure of TAVI being performed on patients. It can also vary according to the condition of the patient at the time of surgery.
- TAVI or TAVR-Synthetic Valve : 3897 USD - 4423 USD
- TAVI or TAVR-Tissue Valve : 3624 USD - 3987 USD
- Transcatheter Aortic Valve Repair : 1231 USD - 2435 USD
Indications for Transcatheter Aortic Valve Replacement
Here are some of the conditions in which the Transcatheter aortic valve replacement is usually recommended. These are:
- Severe symptomatic aortic stenosis
- High surgical risk
- Contraindications to open-heart surgery
- Elderly patients with comorbidities
- Patients with limited life expectancy
- Patients with damaged aorta
- Severe left ventricular dysfunction
- Patients with previous coronary artery bypass grafting (CABG)
- Bicuspid aortic valve with stenosis
- Redo valve replacement with a high surgical risk
Risk factors of Transcatheter Aortic Valve Replacement
Some of the risk factors associated with aortic valve replacement are:
Complications during surgery
There can be excessive bleeding during or after the surgery. There is also a risk of infection in the procedure of TAVI.
Irregular heartbeats
There is the risk of irregular heartbeats in patients going for TAVI procedure. It is a serious condition that should be managed in time.
Kidney damage
Sometimes there is a risk of damage to kidneys during or after the completion of the procedure.
Organ damage
Due to catheter, the organs can be damaged due to poor skill and may further complicate the condition of a patient.
Death
In rare cases, when the patient is not stable, there is a risk of death during or after the procedure.
03/10/2025
