Transcatheter Aortic Valve Replacement
The New Gold Standard for Aortic Valve Replacement in Elderly Patients
Am I a candidate for TAVR/TAVI and what am I to expect prior to and after the procedure?
Therapy for cardiac disease is changing.
In order to secure best possible outcomes for patients the concept of a Heart Team has been adopted.
The Heart Team comprises cardiothoracic surgeons, cardiologists, cardiac anesthesiologists, radiologists, TAVR coordinators, dedicated cardiac care nurses, OR and cardiac cath lab staff who are well versed in the nuances of treatment of structural heart disease.
The entire team sits down and evaluates cases referred for TAVR on an individual basis. If you are intermediate or high risk for surgical aortic valve replacement you might be a candidate for TAVR based on the recommendations of the Heart Team.
Patients considered for TAVR are subjected to further testing to decide the mode of intervention in each individual patient.
These tests may include an ECG, Chest X-ray, Transthoraic echocardiogram (TTE), blood tests, Pulmonary Function Tests (PFT) and a Computerised Tomogram (CT). In addition a Coronary Angiogram (CAG) will be performed if initial testing is satisfactory.
Upon review of the investigative data a decision will be made on feasibility of TAVR and the best approach for the same.
In the majority of cases TAVR is performed using the Trans-Femoral (TF) approach via the vessels in the groin.
If the groin vessels are too small or badly diseased – the procedure may be performed via a small incision in the chest (Trans Apical) or in the upper part of the sternum (Trans Aortic). In the latter two approaches the patient would need a short period of general anesthesia.
Per standard protocol discharge would be in 3-4 days following the procedure.