Minimally invasive aortic valve replacement (miAVR) is a surgical alternative to open heart surgery. It involves placing a new, tissue-based valve in place of the diseased valve.
Patients who qualify for TAVR have several benefits, including lower periprocedural complications and a shorter hospital stay. However, there are some long-term unknowns that remain.
Benefits
Minimally invasive heart surgery can help reduce aortic stenosis symptoms and improve your quality of life. It can also reduce your risk of complications, infection and stroke.
During minimally invasive aortic valve replacement (also known as transcatheter aortic valve replacement, or TAVI), your doctor uses a tube to guide a new aortic valve through a blood vessel in your groin or thigh and into your heart. This approach may be more convenient for you than open-heart surgery, which requires a long hospital stay and a heart-lung bypass machine.
TAVR may be an option for people who are at high risk of complications or death from surgery, such as those with severe aortic stenosis or other health conditions. If you are high-risk, your doctor will talk with you about whether TAVR is right for you.
Complications
Minimally invasive aortic valve replacement (mini-AVR) is an alternative to conventional open-heart surgery for patients with severe aortic stenosis. It reduces the risk of transfusion incidence, postoperative pain, ICU stay, hospitalization and renal failure [1,2].
A study by Medtronic showed that aortic transcatheter aortic valve replacement (TAVI) has similar long-term results to aortic surgical valve replacement (SAVR). Both procedures had low mortality and no major complications after a year.
The PARTNER 2A study was conducted at 10 Italian centers and compared TAVI with surgery to treat aortic stenosis. Propensity-matched comparisons were made based on multivariable logistic regression models.
TAVR is a minimally invasive procedure that involves inserting a special catheter into your artery at the upper thigh. Once it reaches the heart, your doctor places a new valve inside the old one and expands it to fit properly. Then they remove the catheter device, stitch it closed and bandage it.
Preparation
Minimally invasive aortic valve replacement (TAVR) is an alternative to open-heart surgery for people with severe aortic stenosis, who may not be good candidates for traditional aortic valve replacement. It can increase blood flow to the heart and improve symptoms like shortness of breath, chest pain and fatigue.
Your doctor will tell you what to do before the surgery, including stopping certain medications and avoiding smoking. It may take several days for you to recover from the procedure.
There are some risks with minimally invasive aortic valve replacement, including wound infection, bleeding, kidney injury, stroke and heart attack. Your doctor will calculate these risks based on your specific medical condition and talk with you about them.
There are two main approaches for replacing aortic valves: minimally invasive aortic valve surgery, also called transcatheter aortic valve replacement (TAVI), and surgical aortic valve replacement (SAVR). TAVI is often used to replace mitral and tricuspid valves, while SAVR is more common for aortic and bicuspid valves.
Recovery
Aortic valves open to allow blood to flow from the heart into a large blood vessel (the aorta). When there is too much pressure on an aortic valve, it can leak or be damaged. This is called aortic stenosis.
Usually, doctors replace the aortic valve with a mechanical valve or a biological valve made from pig or cow heart tissue. These options are less likely to break down and can help you avoid the need for blood thinning medications.
But both kinds of valves have risks. These include bleeding, problems with the new valve leaking or moving, and damage to your artery from the catheter used during surgery.
Fortunately, many minimally invasive surgical methods have been developed to reduce complications and shorten hospital stays. For example, a procedure that uses a mini-sternotomy – a small incision between the ribs – can save time and pain.
