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Youssef Langlivede

Tavi, a technique to replace an aortic stenosis.

Percutaneous aortic valve replacement (PAVR), also known as transcatheter aortic valve implantation (TAVI) or transcatheter aortic valve replacement (TAVR), is the replacement of the aortic valve of the heart through the blood vessels (as opposed to valve replacement by open heart surgery). 

Aortic stenosis (AS or AoS) is the narrowing of the exit of the left ventricle of the heart (where the aorta begins), such that problems result.

Symptoms often come on gradually with a decreased ability to exercise often occurring first. If heart failure, loss of consciousness, or heart related chest pain occur due to AS the outcomes are worse.

Patients with symptomatic severe aortic stenosis have a mortality rate of approximately 50% at 2 years without intervention. In patients who are deemed too high risk for open heart surgery, TAVR significantly reduces the rates of death and cardiac symptoms.

The replacement valve is delivered via one of several access methods: 
- transfemoral (in the upper leg), 
- transapical (through the wall of the heart), 
- subclavian (beneath the collar bone), 
- direct aortic (through a minimally invasive surgical incision into the aorta), and 
- transcaval (from a temporary hole in the aorta near the belly button through a vein in the upper leg), among others.

Until recently, surgical aortic valve replacement was the standard of care in adults with severe symptomatic aortic stenosis. However, the risks associated with surgical aortic valve replacement are increased in elderly patients

Tavi, a technique to replace an aortic stenosis.

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