What is TAVI? TAVI vs. Open Heart Surgery

Medical advancements have opened up newer, less invasive treatment options for treating serious heart valve conditions. Transcatheter Aortic Valve Implantation (TAVI) is one such innovation, which allows cardiologists to manage aortic valve stenosis, especially for patients who are not ideal candidates for open heart surgery. But how does TAVI compare to conventional surgical methods? Let’s explore the key differences, procedure steps, benefits, and risks of TAVI and open heart surgery.

What is TAVI?

TAVI, also known as TAVR or Transcatheter Aortic Valve Replacement, is a minimally invasive cardiac surgery used for treating aortic stenosis. This medical condition occurs when the aortic valve becomes narrowed due to calcium and plaque buildup. This narrowing of the aortic valve restricts blood flow from the heart to the rest of the body, leading to fatigue, chest pain, shortness of breath, or even heart failure if left untreated.

Unlike open heart surgery, TAVI does not require opening the chest or stopping the heart. Instead, cardiologists insert a collapsible replacement valve through a catheter, usually via the femoral artery (in the groin), and guide it to the heart using advanced imaging techniques. Once the new valve is positioned correctly, it expands and pushes aside the damaged valve, taking over its function of controlling blood flow.

TAVI Procedure Steps

If you are curious to know what actually happens during this advanced procedure, here are the general TAVI procedure steps

• Preparation and Sedation: The patient is given local anaesthesia or conscious sedation.
• Catheter Insertion: A small incision is made in the groin area (transfemoral approach) or chest (transapical approach).
• Guided Navigation: A catheter is guided through the artery to the diseased aortic valve.
• Balloon Inflation (optional): In some cases, a balloon is used to open up the narrowed valve.
• Valve Deployment: The new prosthetic valve is placed within the old valve.
• Catheter Removal and Closure: The catheter is withdrawn, and the incision is closed.

These steps are often completed within 1-2 hours, and patients typically spend only 3–4 days in the hospital afterwards.

Who is an Ideal Candidate for TAVI?

TAVI is especially beneficial for:

• Elderly patients over 70 years
• Those with coronary artery disease
• Patients with a severely calcified aorta
• Individuals who have undergone previous heart bypass surgery
• Patients with kidney failure, lung disease, or cerebrovascular disease

Patients at low, intermediate, or high risk for open heart surgery are all considered potential candidates for TAVI based on thorough evaluation by experienced cardiologists in Bangalore and across India.

Benefits of TAVI Surgery

The benefits of TAVI surgery are numerous, particularly for patients who cannot tolerate traditional surgery:

• Shorter procedure time
• Less blood loss
• Lower risk of infection
• Minimal scarring due to small incisions
• Faster recovery (usually within a week)
• Improved quality of life
• Shorter hospital stay

This makes TAVI an excellent option for patients seeking minimally invasive cardiac surgery at a trusted heart hospital in Bangalore or other cities.

Risks of TAVI Procedure

While TAVI is considered safe and highly effective, like any medical procedure, it carries potential risks:

• Bleeding or vascular complications
• Stroke
• Arrhythmias (irregular heartbeats)
• Valve leakage or malfunction
• Kidney damage (especially in patients with preexisting kidney issues)
• Need for a pacemaker post-surgery

What is Open Heart Surgery?

Open heart surgery refers to a surgical procedure where the chest is opened, and the heart is exposed for operation. It is commonly used to repair or replace heart valves, correct congenital defects, and perform heart bypass surgery (also known as coronary artery bypass grafting or CABG).

During this procedure, the heart is typically stopped, and a heart-lung machine is used to maintain circulation. This method is more invasive and usually involves a longer recovery time and hospital stay.

How is an Open Heart Surgery Done?

Here’s a breakdown of the open heart surgery procedure for valve replacement or bypass:

• General anesthesia is administered.
• A large incision is made along the breastbone (sternotomy).
• The patient is connected to a heart-lung machine.
• The surgeon performs the required repair or replacement.
• The heart is restarted, and the chest is closed using surgical staples or sutures.

This procedure may take several hours and usually requires a hospital stay of 7–10 days, followed by weeks of home recovery.

Benefits of Open Heart Surgery

Despite being more invasive, open heart surgery has its advantages, especially for patients who require complex interventions:

• Long-term durability of valve replacements
• Better visibility and access to the heart during surgery
• Ability to treat multiple conditions in one procedure
• Highly effective for patients with complex coronary or valvular disease

Risks of Open Heart Surgery

• Infection at the surgical site
• Excessive bleeding
• Stroke or heart attack
• Prolonged recovery period
• Lung and kidney complications
• Potential for postoperative cognitive decline

These factors make it essential to evaluate whether a less invasive alternative like TAVI might be more suitable for the patient.

TAVI vs. Open Heart Surgery

Let’s take a closer look at the comparison: TAVI vs. Open Heart Surgery.

Conclusion

In today’s world, patients have more choices than ever before when treating heart valve disease. TAVI has emerged as a breakthrough in minimally invasive cardiac surgery, offering a safer, faster alternative to traditional open-heart surgery, particularly for high-risk or elderly individuals.

That said, open heart surgery remains the gold standard for certain complex cases, especially in younger patients or when multiple heart conditions need to be addressed simultaneously. Both options carry their benefits and risks, and the best approach will always be the one that’s personalised to your medical needs.

Frequently Asked Questions

Is TAVI a better option than open-heart surgery?

TAVI has less risk of death and stroke, shorter hospital stays, and faster recovery—ideal for older or high-risk patients.

Who is not a suitable candidate for TAVI?

Those with severe frailty, active infection, unsuitable valve anatomy, or poor vascular access may not qualify.

What is the age requirement for TAVI?

TAVI is typically for patients aged ≥80, or ≥70 with comorbidities.

Does the TAVI procedure cause pain?

No. It’s minimally invasive and done under local anaesthesia. Most patients feel little to no pain.