If you have been diagnosed with a condition called aortic stenosis, the aortic valve into your heart has narrowed and does not work properly. The aortic valve is very important as it is a one-way valve that allows blood to flow from your heart to the rest of your body.

The aortic valve is usually a flexible structure but can narrow, leak or harden over time. These changes can be due to age, genetic factors, high blood pressure, calcium build up, cholesterol, smoking, infections or may be present at birth.

You may have experienced symptoms such as shortness of breath, chest discomfort, fatigue and dizziness which are all associated with aortic valve disease.

Traditionally, open heart surgery has been the main treatment option for aortic stenosis. However, TAVI/TAVR is a newer, far less invasive alternative.

TAVI is a way of replacing your existing valve with an artificial tissue valve. A successful procedure will relieve you of symptoms of aortic stenosis, improving the quality of your life and potentially increase your life expectancy.

There are two types of valve implants and your doctor will discuss the appropriate choice for you.

TAVI is performed by our expert heart valve team at Sunshine Coast University Private Hospital (SCUPH). Doctors Larsen and Butterly are both accredited TAVI operators with CSANZ.

The procedure is generally performed under a special general anaesthetic provided by our expert cardiac anaesthetist. Sometimes, local anaesthetic and conscious sedation is used instead of a general anaesthetic.

An intravenous line (IV) will be placed into a vein in your arm. This is for the medical team to administer medication throughout your procedure.

Depending on the implant your cardiologist is using, you may also have a temporary pacing wire inserted into a vein in your neck or leg and passed through to the right ventricle of your heart. The pacing wire will then be externally connected to a temporary pacemaker. This will help your doctor control your heart rate during the deployment of the TAVI device. Normally the pacing wire will be removed during the procedure but on occasion it may be left in for a few days.

The TAVI device will sit inside a small metal cage known as a stent, attached to the end of the catheter. Your doctor will carefully pass the catheter via the femoral artery (the main artery at the top of your leg) up to your heart. Sometimes alternative access may be used such as the right subclavian artery in your neck/shoulder.

We perform x-rays and a transesophageal echo (an ultrasound probe inserted into your oesophagus to visualise your heart and valve during the procedure) to help visualise the positioning of the catheter and device.

Once your cardiologist is happy with the location of the TAVI, the new valve will slowly be released and will “self expand”. Alternatively, a small balloon may be used to open up the new valve.

Your diseased aortic valve will not be cut or removed in this procedure. Once completed, the catheter will be removed and the small incision site will be closed. In most cases the TAVI procedure will take about one hour but it can last up to three hours.

You will have further monitoring in recovery or CCU and the usual hospital stay is between one and three days.

After your procedure you’ll be required to take ongoing medication and have follow-up appointments with your doctor.

If you have any future invasive procedures, including dental treatment, make sure you let your treating doctor or dentist know about your valve replacement. You may require antibiotics before any other procedures to reduce the risk of your new valve becoming infected.

If the procedure is performed under a general anaesthetic, please arrange to have a support person (a relative or friend) collect you from hospital. You’ll also need someone to stay with you that night. You should not drive or make any important decisions in the 24 hours following general anaesthetic.

If you have any concerns about your anaesthetic, please discuss them with your doctor as soon as you can.