when I was diagnosed with aeaortic stenosis I hadn't a clue what it was the
only symptoms I had, was chest pains and I was getting out of breath and I
couldn't walk far at all. I'm in my eighties and I thought it was the aging
process this short film will explain what aortic stenosis is and what you
can expect before during and after your Tavi procedure
aortic stenosis is a heart valve disorder. it affects the valve at the exit of the heart between the
main pumping chamber and the aorta which is the main pipe if you like that
supplies blood to the body. in elderly patients particularly the valve can get
sticky can get calcified and restricted so that it doesn't open properly when
that happens it puts a strain on the heart and in the long term that causes
heart failure. primarily a disease of the elderly aortic stenosis effects up to
seven percent of the population over 75. I started to feel breathlessness and it
got to the point where I couldn't even walk a few steps without suffering pain
which brought on the chest pains
it was very tough trying to climb the stairs I couldn't do more than two or
three steps at a time without getting out of breath
I went to my GP who listened to my heart and said I had a heart valve problem and
suggested that i went to Derriford hospital for examination. aortic stenosis
is a mechanical problem and therefore if if the valve is not
replaced unfortunately the medication will not prevent the problem progressing
and therefore a valve replacement is the most effective and only real solution to
the problem. you've been referred for a tavi that's transcatheter aortic valve
implantation, a less invasive procedure for those unable to undergo open-heart
surgery a new valve is inserted in the groin fed up through the femoral artery
and placed inside the old one alternatively it can be inserted via a
small incision between your ribs this is called the transapical or trans iotic
procedure. the introduction of TAVI has has changed the whole landscape of
treating this problem this means that as a large proportion of elderly patients
who would previously not have received treatment and now have options for
treatment so mr. Bose you've already had your coronary angiogram but we need to
do two more investigations before we can proceed, the first is a CT scan and that
is specifically to look at the vessels in your body and make sure that they're
big enough to decide which route we can do the Tavi. "when I had a CT scan I was
told to lay on the table put my hands behing my head and the machine would run up
and down my body but I had a hold my breath for a certain amount of time the second
test that you'll need is an echocardiogram and that is specifically
to look at the heart and the function of the heart and what size valve that you
will need. "once i was informed that i was having the tavi operation i asked a few
questions on what would happen how would it affect me you can see the
wires from your previous heart operation that you had which is why we're doing
the Tavi the hospital organized a test and I had two tests and they lasted
about 30 minutes each time and I was in hospital for about half a day I was
asked to attend a pre-assessment consultation where the nurse took swabs
out of my nose throat and my groin she took some blood and afterwards I was
able to ask about the procedure there we also any other questions you'd like to
ask I'm just a little bit worried about procedure in your situation we're going
to make an incision in the side of the chest between the ribs good a couple of
weeks before you're admitted you'll be sent details of what you need to bring
with you to the hospital
after I settled into the ward, the surgeon came to see me and explained to me what
was going to happen the next morning so we're planning to do this procedure for
you tomorrow morning and as Sam it said would do it through a small cut on the
side I think the cardiologists and then anaesthetists are going to come around and see
you this evening and make sure that you're happy with the anaesthetic
tomorrow . thank you the following morning the theatre team will
collect the patient from the ward and take them to the cath lab where the
procedure is performed and will usually last approximately an hour
after the Tavi procedure you'll be transferred to either the CCU ward or
the ICU ward for careful monitoring you will remain there until your doctor
feels that you can be transferred to a regular hospital ward where you will
continue to be monitored until you're discharged from the hospital usually
within three to four days for a transfemoral procedure or four to five
days for the trance apical procedure. the recovery period after tavi is much
shorter than with open surgery as the size of the incision and the associated
healing and pain is much less therefore patients can return to a fairly normal
lifestyle after just a matter of weeks
when I got home my wife was overjoyed to see the difference in myself and she'd
be very pleased that I had gone through so well I felt like an eighty-year-old
going down back to 40 I could do a lot of things that I couldn't do before
walking no breathlessness at all no pains in his chest everything was fine