Royal Papworth Hospital is recognised as one of the leading centres for transcatheter aortic valve implantation (TAVI).
Since performing our first TAVI in 2008, hundreds of patients have now undergone this pioneering procedure to improve their quality of life without the need for open heart surgery.
Purpose of the procedure
The purpose of the transcatheter aortic valve implantation (TAVI) procedure is to replace the diseased aortic valve without open heart surgery via a minimally-invasive approach.
Aortic valve stenosis (narrowing) leads to obstruction of blood flow out of the heart. It is the most common form of acquired valvular heart disease in the UK, occurring in 2-4% of adults over 65 years-old.
It becomes more common with increasing age, so as our population grows older it will become more of a problem. This disease can cause many symptoms (exercise restriction, breathlessness, chest pain, collapse) as well as premature death. Frequent hospital admissions are often required and overall this can lead to a poor quality of life.
The only proven remedy for the relief of symptoms as well as improved survival isaotic valve intervention. This can take the form of either surgical aortic valve replacement or TAVI.
Whether a patient undergoes surgical valve replacement or TAVI is determined by a variety of factors including the patient's age, presence (or not) of coronary arterty disease,. aortic valve anatomy, surgical risk, frailty and the presence of any other significant health conditions.
What happens during a TAVI procedure
A TAVI procedure allows the aortic valve to be replaced without a major chest operation.
New transcatheter technologies (where a valve is implanted through a small tube similar to keyhole surgery) mean a heart-lung bypass machine is not required as the operation can be carried out while the heart is beating.
The procedure is usually performed from the groin under local anaesthesia and involves the insertion of a new valve inside the pre-existing disease aortic valve.
It's amazing and has given me new life. I'm back gardening and driving the car again.
Wendy
Had a TAVI in 2021
Effects on patients
It is thought that at least one third of patients who could benefit from aortic valve implantation surgery do not receive it. The reasons for this are many. Some patients are deemed to be too high risk or too old whereas others never get referred to the appropriate specialist as it is felt they would not be suitable for an operation. A number of people simply do not wish to undergo major heart surgery.
Royal Papworth Hospital and TAVI
In 2008, Royal Papworth Hospital was one of the first centres in the world to offer this minimally invasive transcatheter valve implantation (TAVI). In 2018, the 500th TAVI was performed.
Today, we are one of the leading hospitals in the UK offering this procedure currently performing in excess of 250 TAVI cases a year.
A team of more than 50 people have been involved with the introduction of this groundbreaking technique which has continued to exapand over the years. It has required a multidisciplinary approach and collaboration between many of the hospital departments. The unique position of Royal Papworth Hospital as a leading centre for cardiothoracic medicine has made it an ideal place to adopt these new treatments.
Useful resources
Undergoing a TAVI procedure
In this video, consultant cardiologist Dr Charis Costopoulos explains what happens during a TAVI procedure. Wendy, a patient in 2021, shares her experiences.