Dr Priya Sharma Healthcare Professional
TAVI or transcatheter aortic valve implantation is a medical procedure that involves the replacement of a blocked or narrowed aortic valve in people who are at high risk or are too sick to undergo open heart surgery.
According to some studies, the average survival rate of a person undergoing TAVI surgery is a maximum of approximately 16 years for patients who are aged 65 years or less. The survival rate will decrease further for patients over 75 years of age.
TAVI surgery involves the implantation of an aortic valve without eliminating the old, damaged aortic valve. TAVI surgery is generally performed in cases of aortic valve stenosis, which is a medical condition that involves the narrowing of the aorta, which is the largest blood vessel that branches off the heart. Narrowing of the aortic valve will prevent the valve from opening completely and reduces the blood flow to the body.
Aortic valve replacement can be performed by surgical aortic valve replacement (SAVR) surgery, which is a type of open surgery, or by TAVI.

Success rate of surgical aortic valve replacement (SAVR):
SAVR can help in treating a faulty aortic valve, decrease unpleasant symptoms, and improve the quality of life of a person.
SAVR generally offers a good long-term success rate for people who undergo the procedure with a biological valve that is made from animal tissue.
Several studies show that people having aortic stenosis who undergo surgery to replace a narrow valve have only a slightly less life expectancy than people who do not have this condition. The post-surgery survival rate is approximately 16 years for patients who are 65 years old or less, to between 6 to 7 years for patients who are above 75 years of age.
The overall mortality rate of SAVR is found to be 2%, which is less than leaving severe aortic disease or disorder untreated which could lead to a mortality rate of 3%.

Success rate of TAVI:
TAVI, also known as TAVR (transcatheter aortic valve replacement), is a minimally-invasive procedure performed to treat aortic valve disease.
The price involves the insertion of a catheter into the leg or upper chest region and passing it to the office valve. The catheter will help in guiding the replacement valve to the aortic valve that will be placed over the damaged, old aortic valve. The new valve will then replace the old valve tissues and leaflets, and take over the regulation of blood flow.
TAVI is considered to be a safer procedure compared to SAVR as it does not involve open heart surgery. TAVI is therefore considered to be a good treatment option for elderly patients who are considered to be unsuitable for SAVR.
Patients above 80 years of age are known to have a survival rate and quality of life after TAVI similar to the matched general population.
According to a 2020 study, a person undergoing TAVI had reduced mortality at one month and one year compared with SAVR.
Although TAVI seems to be a better treatment option than SAVR, the viability of the procedure will depend on the severity of the condition the patient has and the structure of the heart. For example, certain patients may not be eligible for TAVI if their valves are too small or too large.
The durability of the stent used in SAVR is up to 15 years. However, a TAVI valve has an uncertain lifespan. However, TAVI is known to have certain benefits over SAVR, namely the elimination of the need for general anesthesia and a lesser hospital stay of around three days compared to SAVR, which needs a hospital stay of around ten days.
Currently, TAVI is only recommended over SAVR in people who cannot undergo SAVR due to advanced age, the presence of certain illnesses, or frailty. Although TAVI is regarded as a clinically-effective procedure, it is not regarded as a cost-effective means to treat patients who are regarded as intermediate or low-risk for heart surgery for aortic valve disease.

SAVR or TAVI – What is preferred first?
The main concern while opting for SAVR or TAVI procedure for a particular patient is which procedure will have a better long-term outlook.
Most doctors suggest opting for SAVR first for younger patients who are 65 years old or less. Then, if required, the surgeon can perform a TAVI procedure after a decade or so, once the new valve will require replacement.
In the case of older patients who are 80 years old or more, the doctor will suggest a TAVI procedure due to the lesser life expectancy of the patient.

Benefits of TAVI surgery:
The advantages of TAVI surgery are:
Reduced mortality rate
Good alternative to open heart surgery
Prevention of any infection or damage
Short hospital stay of three to five days

Risks of TAVI surgery:
The following complications may be associated with TAVI surgery:
Bleeding
Arrhythmias (abnormalities in the heart rhythm)
Kidney disease
Blood vessel damage or injury
Stroke (reduced blood supply to the brain)
Infection
Requirement for a pacemaker
Replacement valve slips out
https://www.logintohealth.com/blog/en/heart-diseases/cost-of-tavi-in-mum...
Mar 23rd 2023 07:20