TAVI/TAVR (Transcatheter Aortic Valve Implantation) in Mumbai | SL Raheja Hospital

What is TAVI/TAVR and is it available at SL Raheja Hospital, Mumbai?

Transcatheter Aortic Valve Implantation (TAVI), also called Transcatheter Aortic Valve Replacement (TAVR), is a minimally invasive cardiology procedure that replaces a narrowed aortic valve without open-heart surgery. SL Raheja Hospital in Mumbai offers TAVI/TAVR for patients with severe symptomatic aortic stenosis, including those at intermediate or high surgical risk.

In aortic stenosis, calcium deposits cause the aortic valve to narrow progressively, restricting blood flow from the heart to the body. TAVI/TAVR delivers a biological replacement valve via a thin catheter, allowing the new valve to expand inside the diseased valve and immediately restore normal blood flow — all while the heart continues beating.

Who needs TAVI/TAVR? Symptoms and candidacy criteria

TAVI/TAVR is recommended for patients diagnosed with severe symptomatic aortic stenosis. The structural heart team at SL Raheja Hospital evaluates each patient individually before recommending the procedure.

Common symptoms that may indicate the need for TAVI/TAVR:

• Chest pain or tightness (angina) on exertion
• Shortness of breath, especially during physical activity
• Dizziness or light-headedness
• Unexplained fatigue and reduced exercise tolerance
• Fainting or near-fainting episodes (syncope)
• Swelling in the legs or ankles (signs of heart failure)
• Rapid or irregular heartbeat

Factors considered when assessing candidacy:

• Severity of aortic valve narrowing confirmed on echocardiography
• Age, frailty, and overall physical health
• Presence of other cardiac conditions or previous heart surgery
• Kidney function and lung health
• Anatomy of the aortic valve and blood vessels (assessed by CT angiography)
• Surgical risk score and patient preferences

How is TAVI/TAVR performed at SL Raheja Hospital?

TAVI/TAVR at SL Raheja Hospital, Mahim, Mumbai is carried out by a multidisciplinary structural heart team — interventional cardiologists, cardiac surgeons, imaging specialists, and anaesthesiologists — in a specialised cardiac catheterisation laboratory or hybrid operating room. The procedure typically takes one to three hours.

1. Pre-procedure evaluation — Comprehensive workup including 2D/3D echocardiography, CT angiography, cardiac catheterisation, ECG, blood investigations, and pulmonary function tests where indicated. The team reviews all findings to confirm TAVI/TAVR suitability and select the optimal access route.
2. Anaesthesia — Local anaesthesia with conscious sedation or general anaesthesia is administered, depending on the patient's condition and procedural requirements.
3. Vascular access — A small incision is made at the chosen access site (most commonly the groin). The catheter carrying the compressed biological replacement valve is introduced into the blood vessel.
4. Catheter navigation — Under continuous X-ray fluoroscopy and echocardiographic guidance, the catheter is advanced through the blood vessels to the diseased aortic valve.
5. Valve deployment — The replacement valve is precisely positioned inside the calcified native valve and expanded — either by balloon inflation or a self-expanding mechanism. The new valve immediately begins regulating blood flow; the old valve remains in place as a support structure.
6. Confirmation and closure — The team verifies correct valve position, adequate function, and absence of significant leakage using real-time imaging. The catheter is then removed and the access site is closed.
7. Post-procedure monitoring — The patient is transferred to a monitored unit where heart rhythm, blood pressure, and valve function are observed closely before discharge planning begins.

What access routes are used for TAVI/TAVR, and how do they compare?

The structural heart team selects the safest access route based on each patient's vascular anatomy, overall health, and CT imaging findings. The following approaches may be used at SL Raheja Hospital:

All approaches avoid the need to open the breastbone (sternotomy) or use a heart-lung bypass machine in most cases — a key advantage over conventional surgical aortic valve replacement (SAVR).

What is the recovery process after TAVI/TAVR?

Recovery after TAVI/TAVR is significantly faster than after open-heart surgery. Most patients notice improvement in breathlessness and fatigue within days of the procedure. The following milestones reflect a typical recovery pathway:

1. Within 24 hours — Most patients are encouraged to sit up and begin walking with assistance. Continuous monitoring of heart rhythm, blood pressure, and valve function continues.
2. Days 1–3 (hospital stay) — Hospital stay is typically one to three days. The care team confirms stable valve function via echocardiography before discharge.
3. First two weeks at home — Keep the catheter insertion site clean and dry. Avoid strenuous physical activity. Take all prescribed medications, including blood-thinning agents, exactly as directed.
4. Weeks 2–4 — Gradual return to light daily activities such as walking and self-care. Attend the first scheduled follow-up appointment and echocardiogram.
5. One to two months — Most individuals can resume normal daily activities. Continue heart-healthy lifestyle measures: balanced diet, regular moderate exercise, smoking cessation, and blood pressure control.
6. Long-term follow-up — Periodic echocardiograms and clinical evaluations are essential to monitor replacement valve function and overall heart health. Adhere to all prescribed medications and attend every scheduled review.

What are the risks and possible complications of TAVI/TAVR?

TAVI/TAVR is a well-established procedure; however, like all cardiac interventions, it carries potential risks. The structural heart team at SL Raheja Hospital in Mumbai discusses these in detail with every patient before the procedure and takes every precaution to minimise complications.

• Stroke — Caused by small particles dislodging during valve deployment; cerebral protection devices may be used where appropriate.
• Bleeding — At the vascular access site or internally.
• Heart rhythm disturbances — Some patients require a permanent pacemaker after the procedure.
• Paravalvular regurgitation — Leakage of blood around (not through) the new valve; usually mild and monitored over time.
• Blood vessel injury — Damage to the artery used for catheter access.
• Infection — Including endocarditis (infection of the heart valve), though rare.
• Blood clots — Risk reduced by prescribed antiplatelet or anticoagulation therapy.
• Acute kidney injury — Particularly in patients with pre-existing kidney disease.
• Emergency conversion to open-heart surgery — Rare but possible if complications arise during the procedure.

Individual risk levels vary based on age, overall health, and the complexity of the valve anatomy. Your cardiologist will provide a personalised risk assessment during the pre-procedure consultation.

Which specialists perform TAVI/TAVR at SL Raheja Hospital?

TAVI/TAVR at SL Raheja Hospital, Mahim West, Mumbai is performed by a dedicated structural heart team comprising interventional cardiologists, cardiac surgeons, cardiac imaging specialists, and cardiac anaesthesiologists who collaborate on every case.

This multidisciplinary approach — sometimes called a Heart Team — ensures that each patient's anatomy, risk profile, and treatment goals are reviewed from multiple clinical perspectives before a final recommendation is made.

For information about the specific consultants currently available for TAVI/TAVR consultations, please use the booking form on this page or contact the hospital directly at info@rahejahospital.com. The team will match you with the appropriate specialist based on your clinical needs.