What are complications of TAVI?

Transcatheter aortic valve implantation (TAVI) or transcatheter aortic valve replacement (TAVR) is a new, minimally-invasive type of procedure performed to treat aortic valve disease by repairing or replacing a diseased aortic valve. The aortic valve is one of the four valves present in the heart. Aortic stenosis refers to the narrowing of the aorta, which is the large blood vessel that branches off the heart. Narrowing of the aorta prevents the aortic valve from opening completely and reduces the blood flow to the rest of the body, making the heart work harder. TAVI is primarily performed to treat the condition of aortic stenosis. Although TAVI surgery is a minimally-invasive procedure and is known to be a safe and effective procedure, it still carries some risks, like any other surgical procedure. In this article, we will discuss the complications associated with TAVI surgery. Procedure of TAVI surgery: To understand the complications associated with TAVI surgery, it is important to first understand how the procedure is performed in a step-by-step manner. TAVI surgery is performed in the following manner: The cardiologist will perform the surgery under local anesthesia, in which the area of surgery will be numbed, or general anesthesia, in which the patient will be put to sleep during the surgery. After the administration of anesthesia, the surgeon will insert a balloon catheter into an artery situated underneath the collarbone or in the groin region through a small incision or cut created in that area. The balloon catheter will then be guided towards the heart and later positioned within the aortic valve opening. The position of the balloon catheter will be confirmed using an echocardiogram or moving x-ray images. Once the surgeon confirms that the balloon catheter is in its correct position, the balloon will be gently inflated to open up the aortic valve. The surgeon will then implant a new biological tissue valve, which is made up of pig or cow heart tissue, using a metal mesh tube which will help to keep the replacement valve in its correct place. The new replacement valve will either expand by itself, or the surgeon will expand it using a balloon. The new valve will usually be positioned in a manner such that it pushes aside the damaged aortic valve. The balloon will then be deflated and the balloon catheter will be removed. Complications of TAVI surgery: The cardiologist will explain the possible risks and complications associated with TAVI surgery before undergoing the procedure. The different complications that could be associated with TAVI surgery include: Valve leaks: In some cases, the blood may leak around the new replacement valve. This could occur if the size of the replacement valve is not big enough, the new valve did not expand fully, or the new valve has interference due to the build-up of calcium. This condition is known as aortic regurgitation. Arrhythmias: The heart rhythm may become irregular due to TAVI surgery. Need for pacemaker: When the valves open during their placement, they may sometimes press on the electrical system of the heart and make the requirement of a pacemaker necessary. Blood vessel damage: Passing the catheters through the arteries can lead to their potential damage. This damage can usually be repaired by open vascular surgery or through a catheter. Bleeding: The catheter is placed in a large artery in the groin region, therefore there is an increased risk of injuring the artery and causing blockage or bleeding which may need surgical repair. Infection: The procedure may lead to infection in certain patients, either during or after the surgery. Damage to the kidneys: The contrast dye that is used for imaging tests can damage the kidneys. This problem is usually reversible; however, severe cases of kidney damage may need dialysis treatment. Stroke: A small percentage of people who undergo TAVI surgery can develop a stroke due to a decrease in blood supply to the brain. This could occur during the surgery itself, or in the days after the procedure. Life-threatening complications: Certain life-threatening complications that may require emergency surgical intervention include the following: Tear of the aorta wall Perforation of the heart Tear of the root of the aorta, where the replacement valve is placed Dislodgement of the replacement valve Death: Although rare, there is a minor possibility that a person undergoing TAVI surgery may not survive. A person undergoing TAVI surgery needs to contact his or her doctor immediately if any of the following side effects are noticed immediately after surgery: Dizziness Sudden weight gain Light-headedness Shortness of breath Swelling of the ankles Severe fatigue Symptoms of infection, such as fever, swelling, redness, increased pain, and drainage at the incision site Chest pain, pressure, or tightness Fainting