TAVI: Transcatheter Aortic Valve Implantation
A guide to TAVI assessment, Heart Team selection, the procedure, risks and follow-up.
TAVI replaces a severely diseased aortic valve using a catheter-delivered biological valve, most often through the femoral artery. It is an established treatment for selected patients with severe symptomatic aortic stenosis and may also be considered in other carefully evaluated situations.
Heart Team Assessment
Treatment choice between TAVI, surgical valve replacement and continued surveillance considers symptoms, valve severity, age, life expectancy, surgical risk, frailty, coronary disease, aortic anatomy, vascular access and the durability expected from each option. Echocardiography and gated CT are central to sizing and procedural planning.
Procedure and Follow-up
The new valve is positioned within the native aortic valve. Potential complications include bleeding, vascular injury, stroke, leakage around the valve, kidney injury and conduction block requiring a pacemaker. Follow-up assesses symptoms, valve function, rhythm and antithrombotic treatment. Lifelong dental care and endocarditis-prevention advice remain important.
New neurological symptoms, fainting, fever or rapidly worsening breathlessness after TAVI require urgent assessment.
Patient Selection and Procedural Planning
The procedure is considered only when the expected diagnostic or therapeutic benefit is meaningful for the individual patient. Anatomy, prior imaging, symptoms, rhythm or haemodynamic findings, kidney function, bleeding and vascular risk, medicines and reasonable alternatives are reviewed before consent.
Technical Goals and Limitations
Procedural success requires a defined endpoint, but an immediate technical result does not guarantee permanent symptom relief or eliminate the underlying cardiovascular disease. Complex anatomy, previous procedures and associated disease can change technique, success probability and complication risk.
Risks and Safety
Potential risks vary by procedure and may include bleeding or vascular injury, cardiac perforation, rhythm or conduction disturbance, contrast or kidney effects, stroke, infection and the need for urgent additional treatment. The treating team explains the risks that are specifically relevant to the planned approach.
Recovery and Follow-up
Written instructions should cover access-site or wound care, medicines, driving, work, physical activity and warning signs. Follow-up confirms the procedural endpoint, symptom response and any required imaging or rhythm monitoring. Never stop antithrombotic or rhythm medicine without a procedure-specific plan.
Questions to Ask Before the Procedure
- What precise problem is the procedure intended to solve?
- What alternatives are reasonable in my situation?
- What is the expected success rate and the most relevant personal risk?
- What follow-up and medicines will be needed afterwards?
Medical Information Note
This information supports, but does not replace, the individual consent discussion with the treating cardiovascular team.