Transcatheter Aortic Valve Implantation (TAVI) is one of the newest interventions available at KGH and is a minimally invasive procedure that is done to repair a valve in your heart. The aortic valve usually opens when blood is pumped from your heart to the rest of your body, but in some people the valve does not open and close properly. This can put extra strain on your heart and can result in a number of symptoms such as trouble breathing, chest pain, dizziness and fainting spells.
Normally your valve would be repaired during an open heart surgery, however surgery may be too risky for some people who are either too ill or have other medical conditions. The TAVI procedure allows an aortic valve to be implanted using a long narrow tube called a catheter. Usually, the catheter is inserted into a large blood vessel in your groin. At KGH, typically two or three TAVI procedures are performed each month.
What to expect:
- You will be referred to a cardiac surgeon because your aortic valve needs to be replaced. This referral can take place if you are already a patient in the hospital or you may be referred by a physician in the community.
- Your surgeon will determine if you meet the criteria for a conventional open heart surgery or a TAVI procedure. If you are a candidate for a TAVI, planning will begin to prepare for your procedure.
- An angiogram will be done to see if your vessels are the right size for the procedure and to ensure that you do not have coronary artery disease in your heart.
- You will have a CT scan so your doctor can look at the vessels from your neck to your groin to determine the best route for the catheter.
- Once this testing is complete, the results are reviewed by your surgeon and we will book a clinic appointment with you.
- Once it is confirmed that the TAVI procedure will take place, you will meet a cardiologist who specializes in TAVI and/or the cardiac surgeon who specializes in TAVI.
- You will then have an appointment booked for pre- surgical screening at Hotel Dieu Hospital where you will meet with an anesthetist and pharmacist.
- Based on all the information available, medical teams will determine how urgently your procedure will need to be done.
- The cardiac care nursing coordinator will call you to let you know the date your surgery has been scheduled for.
- After your surgery is complete you will be moved to the cardiac sciences unit for recovery.
- You will have a breathing tube, be connected to a heart monitor and have a temporary pacemaker wire running from your neck while you recover. Your breathing tube will be removed within a few hours of surgery
- You will notice that you have two incisions in your groin, one small and one larger incision. This is where the catheter was inserted.
- While you are recovering, you may have some restrictions on your movement while the pacemaker wire is connected, but in general you will be able to sit up in a chair in your room.
- We will monitor you closely, using a cardiac monitor for 48 hours.
- As long as your heart rate is stable, the pacemaker wire will be removed within two days.
- It's important that you begin to move about as soon as possible, so a physiotherapist will visit you soon after your surgery to assist you.
- You should expect to remain in hospital for about three-to-five days after your surgery.
Recovery after the procedure
- You should not drive for two weeks after your procedure.
- You should not lift, push, or pull anything heavier than 5 -10 pounds for two weeks after your procedure.
- Do not swim or have a bath for two weeks. Showering is okay.
- In general avoid all heavy exertion for two weeks.
- We will call you in 30 days to schedule an outpatient ECHO exam.
- Ensure that you take all your medications as prescribed by your doctor.
- Keep your incisions clean and dry at all times.