Transcatheter aortic valve implantation (TAVI), also known as transcatheter aortic valve replacement (TAVR), involves a puncture though the skin into the blood vessels in the groin. It is similar to the approach that is used for a cardiac catheterization of the coronary arteries. The procedure can also be done by making a small incision near the fourth rib.
Candidates for this percutaneous procedure include patients with severe symptomatic aortic stenosis and are deemed inoperable by a surgeon. Inoperability has no single definition but most commonly it is defined as a patient who faces more than a 50% risk of death or severe morbidity following a standard, surgical aortic valve replacement. Candidates typically have one or more of the following characteristics: advanced age, previous heart surgery, severe COPD, severe diabetes, home oxygen dependence, pulmonary hypertension, previous radiation to the chest, a severely calcified aorta (AKA a porcelain aorta) and/or extreme frailty.
The New England Journal of Medicine recently reported that, in patients with severe symptomatic aortic stenosis who are not candidates for surgery, TAVI (aka TAVR) is associated significantly improved survival, improved symptoms, and improved quality of life compared to standard treatment.
More Answers from Mark Russo, MD