TAVI procedure – Transcatheter aortic valve replacement
TAVI procedure or aortic valve transcatheter replacement is often used by leading Israeli heart surgeons to repair the valve. Closed heart catheterization or aortic valve replacement has a significant advantage over open surgery. This is a minimal invasion, minimal blood loss and risks, as well as minimal anesthesia.
Performing the TAVI procedure requires high skill of the surgeon.
We work with leading Israeli cardiac surgeons, heads of cardiac surgery departments and research institutes of the largest Israeli hospitals, who have many years of experience in transcatheter aortic valve replacement.
Our cardiac surgeons perform the TAVI procedure at the leading Israeli hospital Assuta.
The aortic valve, located between the left ventricle and the aorta, allows blood to flow forward and prevents blood flow back to the left ventricle. The valve consists of three leaflets. When opened, they are separated from each other, and when closed, they are closed. In the event of a valve problem, a narrowing or blood leakage occurs.
When is transcatheter aortic valve replacement TAVI needed?
Indication for TAVI procedure is aortic valve stenosis.
Transcatheter access operations have been practiced in Israel since 2010. This advanced technology, called TAVI procedure (Transcatheter Aortic Valve Implant Controlled by Angiography), was developed in Israel and is one of the key in replacing the aortic valve with a new artificial valve without opening the chest.
Preparation for TAVI procedure in Israel
A few days before your arrival in Israel, we will arrange a consultation with one of the leading heart surgeons. Our cardiac surgeons decide on the catheterization procedure only after review tests results and maybe additional examination in Israel.
Before the procedure for replacing the aortic valve, the following diagnostics must be performed:
• Diagnostic coronary angiography for TAVI procedure
• Heart Echo Test – Echocardiography
• Blood tests: general blood count, coagulation, blood chemistry.
The night before the procedure, you must stop eating and drinking. In the morning we will deliver you to the hospital, where the experienced medical staff of the cardiology department will conduct the final preparation before the procedure. You will also need to sign treatment consent forms.
If you have sensitivity to iodine or kidney failure, you should definitely inform the doctor.
Continuous medication should be continued as usual, including during the morning of treatment, with the exception of the following medications:
- ♦ Blood thinners – need a break in taking at least 48 hours before treatment.
♦ Drugs for the diabetes mellitus treatment. It is necessary to stop taking one to two days before and one day after treatment.
For all these drugs consultation with our cardiac surgeon is necessary.
How is transcatheter aortic valve replacement TAVI performed?
During this operation, a biological valve is implanted instead of a faulty valve. A catheter is connected to a failed valve. A new valve is implanted in the old valve, pushes its leaflets and begins to work immediately after implantation.
Our cardiac surgeons perform hundreds of such procedures per year. Experience has shown that such treatment is more effective than open heart surgery. A general approach to performing TAVI procedure on the heart is through the inguinal arteries. In a small number of cases when there are dimensional limitations in the inguinal arteries, a catheter is inserted either through the shoulder region (axilla) or directly into the heart (apical access).
In the operating room, you will be given twilight anesthesia. The area of operation will be shaved and sterile washed before the administration of a local anesthetic. Then the tubes that are used to transplant the valve will be introduced. After this, a contrast agent is introduced, and during the injection, a heat wave is felt, which passes within a few seconds.
The transcatheter aortic valve replacement procedure lasts about 1 to 3 hours. The procedure is painless, but in case of pressure in the chest or groin, or other unpleasant sensations, it is necessary to inform the staff.
After the TAVI procedure
The average hospital stay after transcatheter aortic valve replacement is 5 days, but this period may be shorter or longer, depending on the decision of the doctor. At the end of the aortic valve replacement, you will be transferred to the intensive care unit for 24 to 48 hours, or back to the recovery department for several hours. Then to the cardiology department for further treatment and observation. You can usually get out of bed the day after the procedure.
After transcatheter replacement of the aortic valve, you need to rest and avoid excessive efforts, as well as continue taking the medications prescribed by the Israeli cardiac surgeon. Drugs should not be discontinued without agreement with the cardiac surgeon. Three weeks later, the next consultation of a cardiac surgeon is necessary.
TAVI TECHNOLOGY – A UNIQUE ALTERNATIVE FOR SEVERE DISEASES
Transcatheter replacement of the aortic valve can be indicated for patients who do not respond to drug therapy, but surgery for which is very risky (30-50% of patients). These include patients who underwent heart surgery or patients with serious diseases, such as complex lung diseases, severe heart failure, etc.