The procedure is usually performed in a catheter laboratory or hybrid theatre suite where there is specialised radiology equipment to help with the procedure
There are 2 main ways that the valve can be implanted:
- Transfemoral (Leg artery): This is performed through a small cut into one of your groin arteries and is performed usually under local anaesthesia.
- Transapical (Apex of the heart): This is performed through a small incision in your chest wall and is performed under general anaesthesia.
Alternative less common approaches may be used depending on the patient’s anatomy – Subclavian (Arm artery), Ministernotomy (Breastbone), Minithoracotomy (Between the ribs) or Transcaval (Leg Vein)
A pacing wire is initially placed into a vein in your leg. This wire acts as a pacemaker, allowing the team to temporarily speed up your heart at key points in the procedure. This means that less blood is passing through your aortic valve, enabling to ensure that the artificial valve is positioned correctly.
The TAVI valve is placed by making a small cut in your groin and/or chest. Sheaths are placed in your groin and wrists. Through these sheaths, a fine tube (catheter) is placed to your heart. A deflated balloon is passed through the catheter. When it reaches your aortic valve, the balloon is inflted, widening the valve.
Before your artificial valve can be implanted, it is carefully crimped (compressed) and mounted onto the balloon and then placed through the sheath to your heart. Once it is in place, your artificial valve is expanded by the balloon so that it fits across your existing valve, holding it open permanently. This procedure will improve how well your heart works without you having to have your own diseased aortic valve removed.
When you wake up you may have puncture sites in your groin from the pacing wire and tubes (sheaths) used to get the images we require for positioning the valve. Any incisions are sutured closed.