Catheter-based implantation of an aortic valveHeart valve between the left ventricle and the aorta. It prevents the blood from flowing back into the left ventricle during the relaxation phase. prosthesisReplacement part for a missing or no longer functioning organ or body part, e.g. heart valve prosthesis. – TAVI
The TAVI procedure is available to patients for whom the HEART team recommends performing an aortic valveValve. replacement without opening the chest.
The TAVI procedure is most commonly used to treat aortic valve stenosisAcquired valvular heart defect. The aortic valve narrows so much due to inflammation and/or calcification that when blood leaves the (left) ventricle, it can only enter the aorta by overcoming a high resistance. This narrowing leads to an increased load on the left ventricle..
In aortic valve stenosisPathological narrowing of the heart valves caused by inflammation or calcium deposits. The blood flow is obstructed and the blood can only be forced through the narrowed valve with increased pressure., the aortic valve no longer opens sufficiently due to calcification, and the left ventricleLower chamber of the heart. A healthy heart has two ventricles (right and left). has to apply significantly higher pressure to pump blood into the body. Patients often suffer from shortness of breath, a tightness in the chest, sudden unconsciousness or acute onset of heart failure. This condition can only be treated by implanting a prosthetic heart valveIn the inflow and outflow area of the heart chambers there are valves which prevent the blood from flowing back in the wrong direction. Each heart half has a sail valve and a pocket valve: 1. Tricuspid valve (between the right atrium and right ventricle) 2. Pulmonary valve (between the right ventricle and pulmonary artery) 3. Mitral valve (between the left atrium and left ventricle) 4. Aortic valve (between the left ventricle and the aorta)..
In order to check the feasibility of a TAVI procedure, a computer tomogram (CTComputed tomography.) of the aortaThe main major artery in the body. Leads from the left ventricle via an arch in the thoracic cavity to the abdominal cavity. There it splits into two large iliac arteries. is performed in addition to other examinations. The CT scan allows the size of the patient’s own aortic valve and that of the vessels to be measured precisely. This can then be used to decide what size the prosthetic valve must be and whether the vessels are sufficiently dimensioned for the advancement of an implantation catheter.
If the inguinal vessels are not suitable for a TAVI procedure due to severe calcification or vascularConcerning the blood vessels. stenosisNarrowing of vessels or valves., alternative access routes are available via the subclavian arteryA blood vessel leading away from the heart that transports oxygenated blood to the organs. Arteries pulsate and can be palpated on the wrist, for example (pulse). The aorta is the main artery of the body. or the apex of the heart.
Two hybrid operating theatres are available at the DHM for TAVI procedures. In over 90% of patients, the TAVI procedure can be performed through the groin vessels. This usually does not require the patient to be under general anaesthesiaDrug-induced and controlled unconsciousness with simultaneous suspension of pain sensation, muscle tension, defence reflexes and paralysis of the central nervous system. Only in such a condition can operations be performed on the heart.. Under fluoroscopic control (X-ray fluoroscopy), a guide wire is positioned in the left ventricle. A prosthetic valve is folded into a catheter system and deployed over the guide wire inside the diseased aortic valve. The patient’s own aortic valve is not removed during the TAVI procedure, but is pressed against the vessel wall by the new prosthesis.
The TAVI procedure may also be available to patients who have previously had a biological aortic valve prosthesis implanted. In the event of degeneration, i.e. narrowing or leakage of a biological heart valveHeart valve prosthesis made of biological material (bioprosthesis)., the TAVI procedure can prevent a new chest opening.
