STRUCTURAL HEART INTERVENTIONS

TAVI, or Transcatheter Aortic Valve Implantation, is a minimally invasive treatment for severe aortic stenosis.

Instead of replacing the valve through open-heart surgery, a new valve is delivered using a catheter, most commonly through the femoral artery.

The new valve is positioned inside the diseased native valve and expanded into place.

TAVI can be performed without opening the chest and without the need for cardiopulmonary bypass.

Depending on the patient's condition and the center's protocol, the procedure may be performed using conscious sedation or general anesthesia.

The decision between TAVI and surgical aortic valve replacement should be individualized based on anatomy, age, surgical risk, life expectancy, comorbidities, and patient preference.

The procedure typically takes 60-90 minutes, and patients are generally discharged from the hospital 2-3 days later

TriClip is a minimally invasive, catheter-based treatment for tricuspid regurgitation (TR), a condition in which the tricuspid valve does not close properly and allows blood to flow backward into the right atrium.

During the procedure, a small clip is delivered to the tricuspid valve through a catheter, usually inserted through a vein in the groin. The clip grasps the valve leaflets and brings them closer together, helping to reduce the amount of blood leaking through the valve.

Who May Benefit?

TriClip may be considered for selected patients with significant tricuspid regurgitation, particularly those who:

• Have significant symptoms
• Have suitable tricuspid valve anatomy
• Are at high risk for conventional surgery
• Remain symptomatic despite appropriate medical treatment

Potential Benefits

• Reduces tricuspid regurgitation
• May improve shortness of breath and fatigue
• May reduce leg swelling
• May improve exercise capacity
• May improve quality of life
• Avoids open-heart surgery in appropriately selected patients

Key Message

TriClip, also known as Transcatheter Edge-to-Edge Repair (T-TEER), provides a minimally invasive treatment option for selected patients with significant tricuspid regurgitation.

The procedure typically takes 1-2 hours, and patients are generally discharged from the hospital the following day.

Left atrial appendage occlusion (LAAO) is a non-surgical procedure that closes a small pouch in the heart's left atrium, particularly in patients with atrial fibrillation (AF). During AF, blood can pool in this area and form clots, which can travel to the brain and cause a stroke.

Why Is It Done?

Its main purpose is to reduce the risk of stroke.

It is an alternative treatment option for suitable patients who need long-term blood thinners but have a high bleeding risk, cannot take blood thinners, or have a history of serious bleeding.

How Is It Done?

The procedure is usually performed by entering through a thin catheter from an artery in the groin. The catheter is advanced to the left atrium through a special passage from the right side of the heart, and a special closure device is placed inside the left atrial appendage.

During the procedure, intracardiac imaging methods are used to confirm the device is in the correct position.

• The procedure takes about 1 hour.
• It is usually performed under anesthesia or sedation.
• Most patients are monitored in the hospital for 1 night and can be discharged the next day.

What Are the Risks?

As with any interventional procedure, there are some risks. These include:

• Bleeding or vessel injury at the groin site
• Fluid or blood buildup around the heart (tamponade)
• Stroke
• Device displacement
• Heart or vessel injury
• Rarely, serious bleeding or other serious complications

In suitable patients, LAAO is a minimally invasive and effective treatment option used to reduce the risk of stroke related to atrial fibrillation.