Transcatheter Aortic Valve Implantation (TAVI): Minimally Invasive Heart Surgery

• TAVI is a minimally invasive method of aortic valve replacement surgery, making it a good option for the elderly, patients with underlying diseases and those at high risk
• The TAVI procedure involves reduced risk, less pain and a fast recovery, resulting in better quality of life
• After a TAVI procedure there is usually no need for additional maintenance or treatment, and due to the high durability of the TAVI valve it can usually continue to be used for up to 10 years

Aortic stenosis is most commonly found in the elderly and it is caused by a degenerative change to the aortic valve, resulting in a narrowing of the valve or, in some cases, an inability of the valve to open and close properly. This causes the flow of blood from the heart to various parts of the body to be obstructed or reduced. As a result, the heart has to work harder than normal, which can cause heart failure.

1. Unusually and easily fatigued
2. Feeling faint or dizzy, especially when exercising
3. Chest tightness during periods of exertion

These 3 symptoms are indications that urgent treatment may be needed; otherwise symptoms may worsen.

Conventional treatment of aortic stenosis has long been open-heart surgery to replace the aortic valve. However, some groups of patients may have physical conditions that make them unsuitable for surgery, such as the elderly who often already have underlying diseases and are not as strong as younger people. As a result, surgery may be more difficult in these cases due to a variety of factors.
A minimally invasive procedure called transcatheter aortic valve implantation (TAVI) is considered a good option for this group of patients. It allows them to return to a good quality of life with their loved ones and family and to return to their previous daily activities and lives.

TAVI (Transcatheter Aortic Valve Implantation) or TAVR (Transcatheter Aortic Valve Replacement) is a minimally invasive heart procedure that is used to replace a thickened aortic valve that cannot fully open (aortic valve stenosis), causing degeneration and narrowing of the valve, particularly in older patients, and putting a strain on the heart itself as it has to work harder.

The procedure is carried out by inserting a catheter into a blood vessel. One of the distinctive advantages of this particular method is that the heart doesn't need to be stopped; the procedure can be performed while the patient’s heart is still beating. A TAVI valve is inserted, usually into the arteries in the groin, mounted on another catheter which is threaded through the initial catheter in the blood vessel and across the diseased aortic valve. The new valve is then pushed into place over the original one. The procedure takes only about an hour and, because there is no surgical wound, the recovery period is short, allowing the patient to return home within 2-3 days depending on the patient’s physical condition.

For patients over 80 years of age, treatment using TAVI is the best option as it was developed for elderly and high risk patients. For patients between 70-80 years of age the physicians and heart team must first look at various factors, including the patient's surgical risk, the anatomy of the patient’s heart valves and surrounding area, and other related factors.

TAVI itself is a procedure that has been around for more than 10 years and has become a standard treatment. In the US and Europe, TAVI is now considered the treatment of choice over open-heart surgery for most cases, especially, for example, in cases of patients who have been assessed as being at high-risk for surgery, i.e., if the surgery mortality rate is greater than 4-8 percent. In this group of patients, TAVI is generally the best option.

Generally speaking, the success rate for TAVI is very high, with a mortality risk of less than 5 percent which is considered very low. Other potential risks include bleeding and stroke, with a 1-2 percent average risk.  In certain cases, where there is a 5-10 percent risk, the patient will need to have a permanent pacemaker implanted due to conduction disorders if the heart’s electrical system slows down after the aortic valve replacement. Other risks such as surgical site infection are very low. The patient is able to move around quite quickly after the procedure since the recuperation period is much shorter.

After TAVI treatment, if the procedure goes smoothly, the TAVI aortic valve is in the proper position and there is no valve leakage, there is usually no need for additional maintenance. This is due to the high durability of the TAVI valve, which can usually continue to be used for up to 10 years. In some special cases requiring replacement there is very little risk. In most cases, the patient will follow up regularly with the doctor who performed the procedure or with a heart specialist. Patients do not need a blood thinner after TAVI.

Samitivej Hospital, situated in the heart of Bangkok, Thailand, is equipped with advanced medical technology to provide fast and accurate diagnoses. Using cutting-edge equipment, our experienced cardiologists are able to provide effective treatment for a wide range of diseases and conditions, including congenital heart disease, coronary artery disease, myocardial infarction (heart attack), heart failure, cardiac arrhythmia, rheumatic heart disease, and many others.

The Heart Center, staffed with emergency cardiologists 24 hours a day, offers emergency services. After treatment, we offer rehabilitation services carried out by specialists and physiotherapists to reduce the risk of future complications. Choose Samitivej Hospital in Bangkok, Thailand, for world-class heart care.

• Holistic Approach: Our approach to heart healthcare covers prevention and early detection, ensuring comprehensive care throughout.
• Global Expertise: Our experienced cardiologists have studied at reputable institutions worldwide, including the USA, UK, Canada, Australia, and other countries.
• Diverse Specializations: Areas of expertise cover all fields, including specialists in cardiac catheterization, cardiac electrophysiologists, cardiologists, and more.
• Patient Volume: We care for more than 6,700 inpatient and outpatient heart cases annually, emphasizing personalized attention and care.
• Comprehensive Services: Our services encompass various procedures, including balloon angioplasty, stent placement, radiofrequency catheter ablation, and over 300 cardiac surgeries each year.
• Cutting-Edge Facilities: Our state-of-the-art operating room and Cath Lab, strategically designed to be adjacent to the operating room, are equipped with the latest medical technology.

Choose Samitivej Hospital in Bangkok, Thailand, where our dedicated cardiologists and comprehensive services ensure the highest standard of patient treatment and care.