Aortic valve stenosis
Narrowing of the aortic valve obstructs ejection from the left ventricle.
TAVI
Biological artificial valve implanted at the level of the aortic valve.
TAVI
Biological artificial valve implanted at the level of the aortic valve.
What is TAVI?
The aortic valve is one of the four valves of the heart and separates the left ventricle (the heart's pump) from the aorta (the largest blood vessel in the body). It allows blood to pass from the heart to the rest of the body. Narrowing of the aortic valve prevents blood from
flow normally and becomes responsible for symptoms such as shortness of breath, angina and heart failure.
Treatment for this disease usually consisted of replacing the diseased valve with an artificial valve surgically, using "open heart" surgery.
TAVI " Transcatheter Aortic Valve Implantation" is an alternative method that consists of placing an artificial biological valve at the level of your diseased aortic valve by passing through the femoral artery (in the groin crease). This innovative procedure is performed without surgical opening under X-ray control.
This artificial valve is made of pericardium (a thin membrane that surrounds the heart) of animal origin (beef), reproducing the general shape of a normal aortic valve, fixed inside a tubular and expandable metal mesh (stent). This valve is compressed on an inflatable balloon mounted at the end of a tube (or catheter) and pushed to the heart under radiological monitoring, then placed at the level of the diseased aortic valve by inflating the balloon. Once in position, it is held in place by the sole force of expansion of the stent. The size is chosen according to the size of the aortic annulus (place where the stent will be deployed).
What is the implantation method?
To introduce the artificial valve to the heart, the right or left femoral arterial route is used. However, a femoral arterial caliber greater than 6 mm remains essential for this approach.
The following additional tests are necessary before considering valve implantation: electrocardiogram, echocardiogram (ultrasound study of the heart allowing a detailed analysis of the condition of your heart and the aortic valve). It will be necessary to perform a coronary angiography (evaluation of the condition of the coronary arteries) and especially a CT scan of the aorta and the femoral and iliac arteries. These are tests carried out daily in cardiology. During these tests, the diameter of your aortic annulus (the structure to which the aortic valve is attached) and that of your femoral arteries will be calculated in order to determine if the arterial approach is possible.
Only after these tests have been carried out will it be known whether the artificial valve can be implanted.
Implantation of the bioprosthesis and hospital monitoring:
The femoral artery is accessed by simple puncture and will be closed as far as possible by a percutaneous automatic closure system. After the valve is implanted, you will be admitted to the cardiology intensive care unit for monitoring. In this unit, blood tests will be performed daily and an echocardiogram will be recorded to check that the valve is functioning properly. You will then be transferred to the cardiology unit as soon as your condition is stable. The average hospital stay is 3 days.
Expected benefits:
Based on our current knowledge, and taking into account your clinical condition, the placement of this valve appears to be the best possible solution to improve your symptoms and reduce the risks of your disease in a more sustainable way. The expected benefits of this therapeutic procedure are a rapid improvement in your symptoms (shortness of breath, chest pain, discomfort), an improvement in the contractility and functioning of your heart and, more generally, an improvement in your quality of life.
Risks and side effects:
The risks of the procedure are those of cardiac catheterization, coronary angiography , aortic valve dilatation (a test that has been performed for many years), to which are added the potential risks associated with the implantation of the valve itself. The potential complications associated with these therapeutic procedures are: cardiac rhythm disorders,
vascular complications at the catheter insertion site (hematoma, perforation or arterial obstruction that may require surgical repair), myocardial infarction, embolization of valve material or clots, aortic dissection (tear of the aortic wall), perforation of a heart chamber, stroke, renal failure, endocarditis (infection on the valve), valve displacement, leakage around the valve, valve dysfunction, bleeding requiring transfusion, need for emergency surgery for coronary artery bypass grafting or aortic valve replacement, death .
Aortic valve stenosis
TAVI
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