Proper patient selection and preparation for this technique will require additional tests of
- Detailed transthoracic echocardiogram for severity of aortic stenosis and other cardiac function.
- CT of main arteries for suitable catheter entry site.
- CT and esophageal echocardiogram for aortic valve ring evaluation
- Status of coronary artery which may include noninvasive test, CT scan or coronary angiogram.
- Complete evaluation of the patient comorbid conditions.
Since this is an elective procedure, there should be enough time to complete the necessary investigation and properly patient preparation.
Potential risks of the procedure
Successful implantation: 92%. Risk of heart attack: 1%. Risk of stroke: 2-3%. In hospital mortality 2%. Risk of requiring a permanent pacemaker: 4-20% (Sapien valve), 10-40% (Core valve). Risk of dialysis 2.5%. Risk of major vascular injury at the catheter entry site: 6.5%. Require emergency open heart surgery 0.5%
Recovery in the hospital and at home
This will depend on individual pre procedure comorbid, general condition, motivation and complication that may occur. In general recovering from this procedure is faster than the conventional standard aortic valve open heart surgery. Post op hospital stay is about 5 days. Home recovery is usually much faster than the standard surgery particular with appropriate cardiac rehabilitation medical follow up system.
TAVI/TAVR at Bangkok Heart Hospital
The procedure is done in our new state of the art full function hybrid operating room.