On occasion of World Heart Day 2025, Dr Amit Kumar explains why TAVI is a breakthrough for elderly patients with severe aortic valve stenosis
Dr Amit Kumar, Associate Director & Head- Interventional Cardiology, Sarvodaya Hospital
The advanced age frequently leads to heart problems, one of which is the aortic valve stenosis (narrowing). The aortic valve is tasked with regulating blood pressure between the heart and the body and once it is narrowed or tightened, the heart is forced to work harder to push blood forward and thus the symptoms that are associated with the condition include shortness of breath, chest pain, dizziness and, eventually, heart failure.
For many years the only available procedure to cure severe aortic valve stenosis was the open-heart surgery, or in other words, cutting open the chest and replacing the valve. However, open-heart surgery is a challenging procedure to be performed on the old in terms of their age and / or given if they are suffering from other medical conditions like diabetes, kidney, and or lung disease.
It is in these circumstances that TAVI (Transcatheter Aortic Valve Implantation) has proven to yield effective results. TAVI is sometimes referred to as a game-changer since it offers old age patients with a treatment avenue which is far safer and less painful compared to open-heart surgery.
What is TAVI?
TAVI enables a doctor to substitute aortic valve without the challenging surgical procedure (i.e. opening a chest). Using a small incision (in the leg/groin), a thin tube (a catheter) is inserted. The new valve is inserted in the old and diseased valve, and it starts working when placed there. The whole process is carried out in the state of light anesthesia
Why TAVI is more suitable among the aged?
- No open-heart surgery- There are no holes or need to cut open the chest for treatment
- Less pain and suffering: TAVI is least invasive and thus leads to lesser pain
- Can be conducted to patients with increased risks- It can be conducted even in patients who fail to get the operation due to their age or other illnesses.
- Shortly after the procedure, most patients will experience an improvement in the quality of life due to the enhancement of symptoms such as shortness of breath and fatigue.
Who is TAVI Recommended For?
TAVI is to be prescribed in case of:
- Aortic stenosis among elderly patients (usually above 7075 years old) that is severe.
- High-risk patients that are undergoing open-heart surgeries.
- Patients with the information that they have not been informed that they are safe to have surgery.
Nevertheless, final decision is always made by the experts (consist of cardiologists and cardiac surgeon) depending on the general health statistics, tests and history.
TAVI has become a real breakthrough in the future of heart treatment of older patients with severe aortic valve stenosis. It is less invasive, safer and patients who undergo TAVI are able to resume normal life much earlier than with open-heart surgery.