TAVI Aortic Valve Procedure: A Guide for Older Adults

TAVI (transcatheter aortic valve implantation) has changed how doctors treat severe aortic stenosis in older adults. In the past, open-heart surgery was the only option. Many very old people, or people with other illnesses, could not have it safely. Today the new valve reaches the heart through a blood vessel, with no cut to the breastbone. This guide explains who TAVI is for, the steps of the procedure and the care afterwards.

What is aortic valve stenosis?

The aortic valve opens with every heartbeat and lets blood leave the heart for the rest of the body. Over the years, calcium deposits make its leaflets stiff. The opening narrows and the heart has to push much harder. The condition is common after 75.

Symptoms often start mildly, and families put them down to age. Watch for:

• breathlessness when walking or on stairs.
• chest pain or tightness on effort.
• dizziness or fainting, especially with exertion.
• unusual tiredness and fewer daily activities.

Once severe stenosis causes symptoms, the outlook without valve replacement gets much worse. These signs therefore need a heart check with an echocardiogram.

Who is a candidate for TAVI?

The Heart Team makes the decision. This team brings together interventional cardiologists and heart surgeons. They look at age, surgical risk, the anatomy of the valve and vessels, other illnesses and the patient’s wishes. The European guidelines on valvular heart disease usually favour TAVI for older patients with suitable access through the femoral artery. For younger, low-risk patients, standard surgery often remains a good choice.

Before the decision, the patient usually has a CT scan of the heart and vessels, a coronary angiogram and blood tests. The team also assesses frailty, memory and independence. The goal is not only a successful procedure, but a better quality of life afterwards.

The TAVI procedure step by step

Doctors insert a thin tube (catheter) into the femoral artery in the groin. The catheter travels through the vessels to the heart and carries the new tissue valve in a folded state. At the right spot, the valve opens inside the old one, pushes it aside and starts working at once.

Local anaesthetic with light sedation is usually enough. The procedure takes about one to two hours. Many patients walk the next day and go home within a few days, much sooner than after open-heart surgery.

Benefits and risks, honestly

For the right patient, the benefits are significant:

• No cut to the breastbone: less pain and faster mobility.
• Shorter hospital stay: often just a few days.
• Symptom relief: breathlessness and tiredness usually ease within weeks.

Like any heart procedure, TAVI also carries risks. The main ones are bleeding or damage to the access vessel, stroke in a small share of patients and heart rhythm problems. About one in ten patients needs a permanent pacemaker, depending on the valve type. A small leak around the valve can remain. The contrast dye can also strain the kidneys for a while. The Heart Team discusses these risks with the patient and family before any decision.

Recovery and care at home

In the first days, the patient walks a little more each day and avoids lifting until the groin site heals well. The cardiologist usually prescribes an antiplatelet medicine or, where needed, a blood thinner. The doctor also checks the valve with an echocardiogram at set intervals.

Call the doctor if swelling or pain appears in the groin, or if fever, new breathlessness, dizziness or fainting occur. Good oral hygiene matters. Before dental work, tell the dentist about the artificial valve. The doctor often gives a preventive antibiotic.

Cardiac rehabilitation and gentle, gradual exercise help people return to daily life. Find ideas in our guide to gentle exercise and mobility from ΔΕΛΦΙΝΙ. If the person also has heart failure, read our article on SGLT2 inhibitors in heart failure on our blog.

Support after discharge

Many older people need help in the first weeks with dressing, bathing, taking medicines correctly and checking blood pressure. Tiredness and fear of falling are common. A structured setting with medical follow-up and nursing care can make recovery calmer for the patient and the family. The NHS page on aortic valve replacement also gives practical information for patients.

Frequently asked questions

How long does recovery after TAVI take?

Most patients walk on the first or second day and go home within a few days. A return to usual activities normally takes a few weeks.

How many years does the new tissue valve last?

Current data show that modern valves work well for at least ten years, and longer studies continue. Regular echocardiograms track how the valve works.

Does the procedure hurt?

Usually not much. Doctors numb the entry site and give light sedation. Mild discomfort in the groin may last a few days.

Can every older person have TAVI?

No. The Heart Team makes the final choice between TAVI and surgery. It weighs age, surgical risk, anatomy and the general health of each patient.

For personal advice about your relative, please contact us and we will get back to you.