TAVI: A Non-Surgical Innovation for Treating Aortic Valve Stenosis

     Advances in medicine and public health have led to an increase in the elderly population. Simultaneously, the incidence of diseases caused by organ degeneration has risen, including aortic stenosis caused by heart valve deterioration. Therefore, providing quality care and maintaining good health for the elderly is crucial. The arrival of Transcatheter Aortic Valve Implantation (TAVI) may serve as a new alternative for many people suffering from aortic stenosis.

In the past, aortic stenosis was often caused by rheumatic heart disease, mostly affecting younger patients. However, today the disease is typically caused by valve degeneration. The older a patient becomes, the higher the incidence of aortic stenosis.

What is a heart valve?

     A heart valve is a vital component of the heart. As the heart contracts and blood flows out, the valve closes to prevent backflow, acting like a one-way door. It ensures blood flows in a single direction to the lungs for oxygenation before returning to the circulatory system. If there is a valve leak (regurgitation), blood flows backward. If there is stenosis (narrowing), blood has difficulty passing through. In the elderly, this is caused by physical degeneration, as the valve is constantly moving and under blood pressure.

How well do you know heart valves?

     Degeneration occurs when calcium deposits build up on the valve, causing it to thicken and open less. Patients will experience fatigue, chest pain, palpitations, and swollen legs, followed by arrhythmias, heart murmurs, or frequent fainting. As stenosis worsens, the heart cannot pump enough blood to the body, leading to congestion, eventual heart failure, or pulmonary edema. Statistics show that once an aortic stenosis patient reaches heart failure, the chance of mortality within 2 years is as high as 50%.

Regarding treatment, the global standard for aortic stenosis is surgical heart valve replacement. This is an excellent treatment with a mortality rate of only 1-2%.

Some patients are not suitable for surgical valve replacement

     However, a number of patients with severe aortic stenosis are not suitable for surgery, such as very elderly patients or those who have had previous chest surgery, as well as those with multiple underlying diseases. These patients may face a mortality risk from surgery as high as 20% or more. This is why many patients are not referred to surgeons because doctors assess that they are unfit for surgery.

Non-Surgical Valve Replacement Technology

1. Transcatheter Aortic Valve Implantation (TAVI)

     Current medical science can save patients with severe aortic stenosis by inserting a prosthetic valve (TAVI) via a catheter to replace the old, worn-out valve without major surgery. This method differs from conventional surgery, which requires general anesthesia, opening the sternum, and using a heart-lung machine for 3-4 hours, followed by a hospital recovery of 7-10 days if no complications occur.

2. Biological Tissue Valve Implantation

     This new method involves inserting a specialized tissue valve designed to compress and expand. The valve is placed at the tip of a catheter, which the doctor guides into the old heart valve and then expands with a balloon—similar to opening an umbrella. The expanded valve replaces the deteriorated original one. The catheter can be inserted through the groin, or if those vessels are too small, through a small incision in the ribs directly into the heart's apex. This eliminates the need to open the chest bone, use a heart-lung machine, or stop the heart. The entire process takes about 1 hour, and patients typically recover in the hospital for only 4-5 days.

Non-surgical aortic valve replacement technology: Less time, faster recovery.