TAVI or TAVR, transcatheter aortic valve implantation or transcatheter aortic valve replacement. Dr. Anton Titov, MD. It is a recently approved treatment for aortic valve stenosis. Could you please describe the TAVR or TAVI procedure. Dr. Anton Titov, MD. What is a difference from the classic aortic valve replacement techniques? Dr. Marc Pelletier, MD. TAVI has really been such a changed mechanism and a method of doing cardiac surgery. It's really for me as a cardiac surgeon has been the biggest advance in cardiac surgery that I've seen in my short career. It really began with Dr. Alain Cribier in France about 15 years ago. The idea was to utilize what some of our cardiology colleagues were doing with stents in coronaries. But it was adapted to do the same thing for the aortic valve. TAVI procedure involves a groin incision in about 90% of patients. Surgical approach is through the groin. It is through the femoral artery. There are two small incisions on each side. They are less than a centimeter in length. Dr. Marc Pelletier, MD. Surgeon advances a catheter up to the artery that is at the groin. It goes though the femoral artery, then going up into the aorta and across the aortic valve. Dr. Anton Titov, MD. The idea of TAVR is this. You go inside of the old heart valve. You push it off to the side. Inside this space you leave a new heart valve. It has a stent around it. That new valve will now be the patient's new aortic valve. That has helped many patients. TAVI procedure removed the old method of doing surgery. Previously a heart surgeon had to do an incision on the sternum or even an incision between the ribs. TAVI / TAVR has taken that completely away. Dr. Marc Pelletier, MD. Traditionally patients would need to go on a heart-lung machine. Patients would go under a general anesthesia. Patients would go into an ICU for a day or two. A hospital stay would be about five days. The TAVI / TAVR procedure now allows for the same procedure to be done without general anesthesia. It's a procedure that is about an hour to hour and a half in length. Previously heart valve replacement took three or four hours. Patients don't go to an ICU, they go straight to a recovery area. Instead of spending five days in hospital, they usually go home the next day. They have no restrictions in terms of lifting weights. Dr. Marc Pelletier, MD. Only a few days of activity restrictions are required. They have no pain apart from a little bit of soreness in the groin. TAVI really revolutionized how we can replace aortic valve for a lot of patients. Dr. Anton Titov, MD. It's been really remarkable to see!
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