Is TAVI a major surgery?

Transcatheter aortic valve implantation (TAVI) or transcatheter aortic valve replacement (TAVR) is a minimally-invasive procedure and not a major surgery. People who have aortic valve stenosis suffer from an improperly functioning aortic valve and may have difficulty performing routine activities like climbing stairs or walking. For such people, aortic valve replacement is considered to be a good treatment option. TAVI procedure involves repairing a damaged aortic valve by fitting an artificial valve onto it. TAVI is generally recommended if the cardiologist feels that a particular patient is not fit for open-heart surgery and also if medications fail in improving the symptoms of the patient. In this article, we will discuss in detail TAVI surgery. When is TAVI performed? TAVI surgery is recommended in the following cases: Severe aortic valve stenosis Contraindicated open heart surgery due to the presence of certain health disorders, like lung disease or kidney disease Presence of a biological tissue aortic valve that is not functioning well What are the symptoms of aortic valve stenosis? The following symptoms may be associated with aortic valve stenosis, which indicates the need for undergoing TAVI surgery: Chest pain Breathlessness Fatigue Fainting Shortness of breath Dizziness How to prepare for TAVI surgery? Ask the doctor about your usual medications, and whether or not to continue them or not before the procedure. You may be told to stop blood-thinning medications and certain diabetic medicines at least three days before the procedure. You will be asked to not eat anything six hours before the procedure. You will be told to avoid drinking clear fluids like water and tea without milk at least two hours before the procedure. You will be asked to remove all your jewelry and change into a hospital gown before the procedure begins. How is TAVI surgery performed? The following steps are followed during a TAVI procedure: The surgical area is numbed by either using local anesthesia (numbing the treatment area) with sedation or general anesthesia (putting the patient to sleep during the procedure) may be administered. The doctor will insert a balloon catheter into an artery either in the groin region or underneath the collarbone. The balloon catheter will be guided into the heart and positioned within the aortic valve opening. The doctor will gently inflate the balloon to open up the valve. The doctor will then implant a new aortic valve by using a metal mesh tube which will keep the valve in place. The new valve will either expand by itself or will be expanded using the balloon, depending on the type of artificial valve used. The new valve will be positioned to push aside the damaged aortic valve. The balloon will then be deflated and the balloon catheter will be removed. What happens after a TAVI surgery? After the TAVI surgery, you may be shifted to the intensive care unit (ICU) for recovery before the final discharge from the hospital is given. The doctor prescribes blood-thinning medications to prevent the formation of blood clots in the legs after the procedure. The patient needs to stay active after the procedure to limit the formation of blood clots. What are the do’s and don’ts after TAVI surgery? The patient needs to avoid lifting heavy objects for at least six weeks after the procedure. Avoid driving, cycling, and swimming for a few weeks after surgery. Keep walking and moving around to prevent the formation of blood clots. Eat small, frequent meals to avoid feeling fatigued after the procedure. It is normal to have some swelling in the legs post-surgery. Contact your doctor immediately if you have bleeding from the groin region that does not disappear on its own. What are the risks of TAVI surgery? Although TAVI surgery is not a major surgery and is considered to be a comparatively safe procedure, it may be associated with a few risks, like: Stroke (reduced blood supply to the brain) Kidney failure and damage Blood vessel damage Leakage of the valve (aortic regurgitation) Death What are the benefits of TAVI surgery? TAVI surgery has the following advantages: Shorter surgery time Short hospital stay Less risk of complications Less pain Short recovery time Improved quality of life Improved life expectancy What is the cost of TAVI surgery? The cost of TAVI varies depending on the age and overall health of the patient, the severity of the condition present, and the expertise of the cardiologist who will be performing the procedure. The cost will also vary depending on the locality and type of hospital chosen for treatment. On average, the cost of TAVI surgery in India varies between INR 19,00,000 to INR 25,00,000. Conclusion: Many doctors prefer to treat aortic stenosis with minimally-invasive TAVI surgery instead of more extensive open-heart surgery. The durability of the TAVI valve is however considered to be less than the replacement valve used in open surge