Sandbox:TAVI

Overview

Until recently, aortic valve replacement (AVR) was the only effective treatment for severe symptomatic aortic stenosis. Global aging has raised concerns about safety and possibility of surgical procedure in old patients with associated co-morbidities. Transcatheter aortic valve replacement (TAVR) created a new era of safety for this population and enabled physicians to replace the stenotic valve with more certainty. In Transcatheter Aortic Valve Replacement (TAVR) also known as Percutaneous Aortic Valve Replacement (PAVR), a synthetic valve is advanced to the heart through a small hole made in groin. This procedure is similar in its mechanism to the insertion of a stent, or performing balloon angioplasty albeit with much larger equipment. Traditional aortic valve replacement is an invasive surgical procedure, with considerable mortality and morbidity, especially in more fragile patients. In the newly developed TAVR procedure, the dysfunctional aortic valve is replaced percutaneously, which obviates the need for open heart surgery.

Patient selection, selecting the appropriate imaging modality, preprocedure evaluation, selecting the appropriate valve type and valve size, post procedure complications and long term follow up are the main area of focused importance.

We will describe these factors based on the recent expert consensus for TAVR procedure.