- Valves/Structural

TAVI implant

These are procedures that take place in the catheter laboratory under local anaesthetic and sometimes with the addition of sedation administered into a vein. The procedure can be a day case procedure or sometimes requires an overnight stay. This procedure is performed if you have an issue with the electrical functioning of the heart.

The ablation procedure is slightly different depending on the underlying condition that is being treated.

Some examples of these procedures are described below.

Transcatheter aortic valve implantation (TAVI) is a keyhole procedure designed to treat a condition known as aortic stenosis. This is a narrowing of one of the valves in the heart.

The technology has been in general use since around 2008. The procedure is carried out in our catheter laboratory (operating theatre) by a Cardiologist and is considered a ‘keyhole’ procedure. You may be offered a TAVI as an alternative to a surgical aortic valve replacement once you case has been discussed in a multi-disciplinary team meeting.

You will usually be asked to come into hospital the day before or the morning of the procedure. The majority of these procedures are now performed under local anaesthetic with some sedation given via a drip inserted into your arm. Most TAVI procedures are performed via a keyhole approach in the leg. Sometimes it is necessary to access the heart via a different access point and if this is the case you will undergo a general anaesthetic.

If you are having a ‘trans-femoral’ TAVI (the most usual type), then your groins will be cleaned and drapes applied. Local anaesthetic will be administered to your groins and tubes (catheters) placed in each groin for the procedure. Under x-ray guidance the tubes will be steered up into your heart. The new aortic valve is loaded onto a tube and positioned in place. This pushes your old diseased valve out of the way. The TAVI valves are made of pig tissue loaded onto a special metal frame which moulds to the shape of your old aortic valve. Your doctor will ensure that the valve is working well with no leaks before they finish the procedure. The puncture site in your groin is closed with a special device which stitches the artery back together.

You will usually return to the Coronary Care Unit following the procedure for a period of close monitoring and should expect to stay in hospital at least 1-2 days following the procedure.

Even though TAVI is considered a ‘keyhole’ procedure it is still a major operation and can be associated with complications. These complications vary according to each individual case and your Cardiologist will discuss these with you when you sign the consent form for the procedure.

Main points

1. A 'keyhole' treatment for aortic stenosis, a narrowed heart valve

2. Usually needs a hospital stay of 1-2 days after the procedure

3. Mostly now performed under local anaesthetic with sedation

You should always talk to your healthcare team about any procedure you're going to have and make sure it is right for you.

Francone, et al. Eur Radiol 30, 2627–2650 (2020).

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