Aortic Valve Replacement (TAVI)

TAVI does not involve a chest incision, stopping the heart, or connecting a cardiopulmonary bypass machine. It is a gentler method with faster recovery, suitable for patients at high risk from open surgery. In open replacement, the valve is changed through a sternal incision on a stopped heart.

TAVI is indicated for severe (stage 3) aortic stenosis with symptoms — shortness of breath, chest pain, dizziness, fainting. The method is primarily recommended for elderly patients, those with contraindications to open surgery, or those with comorbidities that increase surgical risk.

The heart team makes this decision individually. Limitations may include the anatomy of the valve and vessels, active infection, blood clots in the heart chambers, and conditions where the procedure would not improve the prognosis. A doctor provides an accurate assessment after examination.

At Pirogov Clinic in Saint Petersburg, TAVI is performed free of charge under the CHI policy and federal high-tech medical care quotas, subject to indications and referral.

A referral and confirmed indications are required. Book a consultation — our specialists will assess your case and help you arrange the quota (HTMC) and prepare the necessary documents.

The procedure itself usually takes 1 to 2 hours. The exact time depends on the patient's anatomy and the access chosen.

TAVI can be performed under general anesthesia or under local anesthesia with sedation — the choice depends on the patient's condition. Not requiring general anesthesia is one of the method's advantages for frail and elderly patients.

Usually the patient spends 1 day in intensive care, then 4–5 days on the ward before being discharged home. Recovery after TAVI is significantly faster than after open surgery.

Modern bioprostheses last an average of 8 to 15 years — the exact lifespan depends on the patient's age, activity level, and adherence to the doctor's recommendations.

TAVI shows high survival rates and good long-term outcomes. Without treatment, severe aortic stenosis sharply reduces life expectancy once symptoms appear, whereas timely valve replacement returns the patient to a normal life.

Years later, once the bioprosthesis wears out, it can be replaced again using the "valve-in-valve" technique. This is also performed transcatheterly, without a chest incision.

TAVI is a well-established, safe method, especially for patients at high risk from open surgery. Like any procedure, it carries small risks (rhythm disturbances, access-site complications), which are minimized by an experienced heart team and modern equipment.

Warning signs include shortness of breath on exertion or at rest, chest pain or pressure, dizziness and fainting, and rapid fatigue. If these symptoms appear with known stenosis, see a cardiologist as soon as possible.

Before TAVI, echocardiography, cardiac and vascular CT, coronarography, and other studies are performed to assess the valve anatomy and select the prosthesis. The attending physician draws up a detailed preparation plan during the consultation.