Transcatheter Aortic Valve Implantation or TAVI is also referred as Percutaneous Aortic Valve Replacement or PAVR. The treatment is needed to treat Aortic Stenosis. The Aortic Stenosis is a condition, where the aortic valve gets narrowed and resultantly, the flow of blood from the heart would be obstructed. The result of this is heavy work load to pump the blood that needs to be flowing throughout the body.
The procedure TAVI involves the replacement of this aortic valve by an artificial valve or Edwards Sapien Transcatheter Heart Valve or THV. This artificial valve is specially designed to suit to be inserted into the heart. The artificial valve consists of metal stent and valve leaflets. The metal stents are made out of cobalt-chromium or steel and is used to function as a device to secure the valve in the position it is placed. The valve leaflets are made from the biological material, typically taken from the cows and it helps to ease the blood flow out from the heart.
Transcatheter Aortic Valve Implantation or TAVI procedure in India done at top heart hospitals by India’s best team of highly skill heart doctors specializes in conducting TAVI procedures.
Advantages
- Candidates, who are highly at risk with the open heart surgery get better treatment with it.
- Further damage to the heart can be prevented.
Eligibility
Before the procedure is conducted, the candidate is evaluated for the TAVI procedure. The evaluation of the candidate is done to check if the TAVI possible and feasible or not for solving the heart problem.
Before Procedure
Once the candidate is eligible for the TAVI procedure, the candidate will be undergoing through the following examinations and investigations.
- Angiogram
- CT Scan
- Chest X-ray
- Overall physical examination
- Blood tests
Procedure
There are two accepted and followed procedures existing for TAVI. These are transfemoral and transapical TAVI.
- Transfemoral TAVI
Transfemoral device is employed in this procedure for implanting it through the blood vessels present in the leg. It needs to assure the size of the blood vessels, whether those are big enough or not for this device or not. So, CT scan and or/ angiogram is then performed before this procedure is conducted. The implantation needs a crimping device to crimp the device carefully and compress it to the size required to fit it into the femoral artery. Then a balloon delivery catheter, which is a specially designed device is used to carry the THV device to the destination in the heart and then towards the aortic valve. The balloon is then expanded after fitting in the right position inside the stenotic aortic valve. It helps to permanently hold the valve. Once the valve is placed in its right place, the delivery system will then be removed from the place of femoral artery. Then the artery will be closed with the help of special suture device, which is exclusively designed and used for this purpose. After the procedure is performed, the candidate will be transferred to CCU or Coronary Care Unit.
- Transapical TAVI
Transapical TAVI procedure is performed for the candidates, for whom transfemoral approach is not feasible, in the cases like the arteries of such candidates are too diseased or too small. This approach makes use of the delivery system for THV implantation, where the implantation is done through the apex or tip of the heart. A small incision is made just below the left nipple and between the ribs. The delivery system is passed though the apex of the heart to reach the right place at stenotic aortic valve, along with the crimped THV. Then the same balloon is used to expand the valve and ensures the fit in the stenotic aortic valve and helps holding it permanently open. Once this procedure is completed, the candidate will be transferred to the CTICU or Cardiothoracic Intensive Care Unit.
After Procedure
After transferring to the CTICU, the candidate is monitored closely and will be on ventilator support under sedation. After 24 hours, ventilation is removed to breath own. The candidate may need to stay in the hospital from 5 to 7 days.
Cost of Transcatheter Aortic Valve Implantation
The above Package Cost is a tentative Approximate Package Estimate, which includes initial investigations & specialists screening, stay in a Private Room wherein patient’s assistant or relative can also stay with patient, doctor / surgeon fee, nursing care, medicines & consumables, Airport Pick-Up & Drop.
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