TAVI Explained: Why Replacing a Heart Valve Without Open Surgery Takes a Whole Team

Her father moved to Dubai to live with the family after he retired. Lately, he has been stopping halfway up the stairs, and last week he felt faint in the car park. The cardiologist hears a loud murmur, orders an echocardiogram, and uses a term the family has never heard: severe aortic stenosis. Then another one: Transcatheter Aortic Valve Implantation (TAVI). 

The Problem TAVI Solves

The aortic valve sits between the heart’s main pumping chamber and the aorta, the large artery that carries blood to the body. With age, it can become thickened and stiff with calcium so that it no longer opens fully. This narrowing, aortic stenosis, forces the heart to work harder. Symptoms include breathlessness, chest tightness, dizziness, fainting and tiredness. 

Once severe aortic stenosis causes symptoms, it tends to worsen, and medicines cannot fix a narrowed valve. The valve itself has to be replaced. 

How does TAVI Differ from Open Valve Surgery?

For decades, the only option was surgical valve replacement, which involves opening the chest and using a heart-lung machine. It remains a very effective treatment, particularly for younger patients. 

Transcatheter aortic valve implantation (TAVI), also called TAVR, takes a different route. A new valve, compressed onto a catheter, is usually passed through an artery in the groin and guided up to the heart. Once in position, it is expanded inside the old valve, pushing the diseased leaflets aside. The chest is not opened, and the heart keeps beating throughout. 

Why it Takes a Whole Multi-disciplinary Team

This is where TAVI differs from many procedures. Guidelines recommend that the choice between surgery and TAVI is made by a heart team, not one doctor. An interventional cardiologist and a cardiac surgeon weigh the options together. An imaging specialist reviews a detailed CT scan to measure the valve and check the arteries in the legs. An anaesthetist plans sedation or anaesthesia.

Other specialities often join in. Kidney function matters because CT and the procedure itself use contrast dye. Diabetes and lung disease affect risk. Many patients also need a dental check to rule out infection before a new valve goes in. For frail older adults, an assessment of mobility, memory and overall health helps judge who will genuinely benefit. 

This is where the word multispeciality stops being a marketing term. Families looking for the best multispeciality hospital Dubai has to offer for a parent’s valve procedure are really asking whether all these specialists work together under one roof, and whether they talk to each other. 

What does TAVI Recovery Involve? 

TAVI is often done under sedation rather than full general anaesthesia and usually takes one to two hours. Many patients are walking the next day and home within a few days. Breathlessness often improves quickly. 

Risks include bleeding or damage at the access site, stroke, a leak around the new valve and disturbance of the heart’s electrical system. Some patients need a permanent pacemaker afterwards. The heart team should explain how these risks apply to you personally. 

Life with a New Valve 

Most patients are prescribed blood-thinning medicine for a period after the procedure and have regular echocardiograms to check how the valve is working. Good dental care matters for life, because infection can settle on artificial valves. Tissue valves used in TAVI do wear over time, which is one reason age and life expectancy feature so heavily in the choice between TAVI and surgery. 

For many older patients, though, the change is striking. People who could barely manage the stairs are often back to walking, travelling and playing with grandchildren within weeks. 

Questions Families Should Ask

• Why TAVI rather than surgery, or the reverse?
• Who is on the heart team?
• What will the pre-procedure CT and other tests look for?
• What happens if a pacemaker is needed?
• What does recovery at home look like, and whom should we call with concerns? 

Where is TAVI Available in Dubai?

Aster Hospitals, which operates in Dubai through Aster Cedars Hospital in Jebel Ali and hospitals in Al Qusais, Muhaisnah and Mankhool, provides TAVI/TAVR treatment in Dubai within its cardiology department. Interventional cardiologists, cardiothoracic surgeons, radiologists, and anaesthesiologists evaluate candidates, using cardiac imaging for planning.

After the procedure, patients are monitored in intensive care or a step-down unit (a ward with close monitoring). Nephrology, endocrinology and pulmonology teams can contribute when wider health issues need attention. 

For the family on the stairs, the key message is reassuring. Severe aortic stenosis is serious, but it is treatable, and older age alone is rarely a reason to rule treatment out.