TAVI – Transcatheter Aortic Valve Implantation
Catheter Treatment for Aortic Stenosis (AS)
Transcatheter Aortic Valve Implantation: TAVI
① What is Aortic Stenosis (AS)?
Aortic stenosis is one of the heart valve diseases affecting the valves that separate the chambers of the heart. It is a condition where the aortic valve gradually hardens and fails to open properly due to age-related calcification (calcium deposits) or congenital abnormalities. As a result, it becomes difficult for the heart to pump blood to the rest of the body. With Japan’s super-aging society in recent years, the number of patients with aortic stenosis is on the rise.
② Symptoms of AS
The main symptoms include chest pain, shortness of breath, and fainting. Other symptoms range from dizziness, palpitations, fatigue, loss of appetite, and swelling in the legs. As the disease progresses, it impairs the heart’s pumping function, ultimately leading to heart failure and potentially shortening life expectancy. AS can progress slowly over a long period without symptoms, so patients may mistake it for normal aging. Once symptoms appear, the prognosis worsens, making timely treatment crucial. Generally, without treatment, life expectancy is reported to be 5 years after chest pain onset, 3 years after fainting, and 2 years after heart failure develops.
③ What is TAVI?
To fundamentally resolve AS, the damaged valve needs to be replaced with a new one. The established treatment method has been Surgical Aortic Valve Replacement (SAVR). While this is a highly reliable treatment, it requires opening the chest (thoracotomy) to expose the heart and replacing the valve while the heart is stopped (using a heart-lung machine). This treatment is relatively demanding on the body. For elderly patients, those who have previously undergone open-heart surgery, or those with other dependent conditions, this surgery may be too risky.
Transcatheter Aortic Valve Implantation (TAVI) is a less invasive treatment compared to surgery and has been covered by insurance in Japan since 2013. TAVI is a treatment method that delivers and places a new valve (bioprosthetic valve) in the heart through a catheter inserted into the patient’s blood vessel (usually at the base of the leg) without the need for highly invasive procedures like thoracotomy. The development of this treatment has made it possible to provide effective treatment even for patients who are not suitable for open-heart surgery, and due to its lower physical burden, it allows for earlier mobilization and discharge.
④ Treatment Process
For pre-operative evaluation, outpatient blood tests, cardiac ultrasound, chest X-ray, contrast CT scan, and if necessary, catheter examination are performed.
After that, our hospital’s Heart Team will hold a conference to propose the most appropriate treatment method.
You will be admitted to the hospital the day before the catheter procedure, and TAVI will be performed under general or local anesthesia in the hybrid operating room on the day of treatment. After the procedure, you will receive comprehensive care in the intensive care unit, and rehabilitation may begin as early as the next day. You will be discharged after confirming the condition of the valve and overall health status. The minimum hospital stay is about 4 nights and 5 days.
⑤ Strengths of St. Luke’s International Hospital
1. Comprehensive Support System by the Heart Team
Our Heart Team, consisting of catheter treatment specialists, cardiac ultrasound specialists, cardiovascular surgeons, anesthesiologists, nurses, clinical engineers, radiologists, and physical therapists, provides optimal treatment for patients. In addition to maintaining a high standard of medical treatment, all multidisciplinary staff, including nurses and physical therapists, function at a high level, providing comprehensive support from pre-operative care to post-operative rehabilitation and outpatient follow-up.
2. Seamless Collaboration Between Medical Departments
Managing comorbidities is essential when treating high-risk patients. Our hospital has many specialized departments and values interdepartmental collaboration, allowing patients to receive specialized support for conditions other than heart disease with peace of mind.
3. Safe, Secure, and Comfortable Recovery Environment with All Private Rooms
If post-operative progress is favorable, patients may be moved to the general ward as early as the day after surgery to focus on rehabilitation (*depending on individual patient progress). All general wards in our hospital are private rooms, allowing patients to relax in a quiet environment and focus on post-operative recovery. This not only ensures privacy but also provides a safe and secure environment by reducing the risk of infection from other patients.
