Aortic stenosis is the most commοnly acquired heart valve disease. When severe, it can cause shortness of breath (dyspnea), chest pain (angina) or loss of consciousness (syncope).
The transcatheter aortic valve replacement/ intervention (TAVI) is an invasive procedure, which took place for the first time in 2002. In the beginning, this method was applied as an alternative to the classical surgical aortic valve replacement to patients who were at high surgical risk. In the last years, there has been a development of this method (both from a technical point of view and from the quality of the implanted prosthetic valves) so that it can also be applied to patients at intermediate or even low surgical risk.
In 80-90% of the cases, this procedure takes place through the femoral artery. Sometimes due to stenosis or other anatomical issues of the pelvis arteries, which makes the advancement of the valve impossible, alternative access sites are used, most common being the subclavian or the axillary artery or through a small incision at the apex of the left ventricle of the heart (the latter being a surgical procedure).
There is no need for general anesthesia to perform this procedure as it is performed on a beating heart.
The prosthetic valve is advanced over a guiding wire to the heart. The valve is sewn on a metallic stent-frame and when it reaches the prespecified point in the annulus of the native valve, it is released inside the native valve, which is then pushed to the side.
It is a minimally invasive procedure and in most cases its duration is between 60 and 90 minutes.
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