What is it?

Transcatheter aortic valve implantation

An aortic valve stenosis is one of the most common valve diseases. It is a narrowing of the aortic valve (valve at the heart’s exit). The heart is forced to work harder to pump the blood to the rest of the body through a narrowed aortic valve.

If the patient's general condition allows, this may be treated surgically. If this is not possible, or if the surgical risk is too high, a percutaneous valve implantation may be proposed. This is a biological artificial valve, which is implanted using a catheter where the aortic valve is located. The catheter is usually introduced via an artery in the groin or shoulder.

What is the process?

Preparation

You will be admitted to the Cardiology Department one day before the procedure. The nurse will accompany you to your room, where you will be able to make yourself comfortable. Blood draws will be performed that day and an IV line will be placed. You may take your medication as agreed with the physician.

You will be given a gown to wear. An electrocardiogram will be performed and you will receive additional preparation for the procedure.

dThe procedure is performed in the cardiac catheterisation room.

The procedure

You take place on the examination table. Adhesive electrodes are placed to monitor your heart rhythm. The anaesthetist takes care of the anaesthesia. You will be fully asleep during the procedure. You will be covered with a sterile sheet with a few cut-outs to allow for access to the veins in the groin or shoulder, according to the anticipated access point.

A catheter will be placed at the site of the aortic valve to monitor the position. Various catheters will monitor blood pressure and heart rhythm during the procedure. If necessary, these catheters will be left in place for a few hours or days after the procedure. As soon as the heart valve is in good position, the catheters will be removed and blood loss will be checked.

You will wake up in Intensive Care, where you will stay for 24-48 hours.

What are the risks?

This procedure is only performed on people who have a surgical risk that is too high. A percutaneous aortic valve implantation is a less risky procedure, but complications cannot be ruled out. In order to minimise the chance of complications, we follow an extensive preparation and selection process.

Some possible complications include:

  • bleeding from the puncure site
  • need for a definitive pacemaker
  • embolisation of plaque or a clot, which could cause stroke
  • cardiac tamponade
  • paravalvular leakage
  • late-onset infection of the valve prosthesis

Results

Rehabilitation usually goes smoothly and you will be able to go home three to five days later. After the procedure, the aortic valve's resistence will return to normal.

Centres and specialist areas

Cardiology

Latest publication date: 28/07/2021
Supervising author: Dr Provenier Frank