Trusted medical platform in Jordan
زراعة الصمام الأبهري بالقسطرة
Transcatheter aortic valve implantation (TAVI/TAVR) replaces a narrowed aortic valve with a prosthetic valve delivered folded through a catheter — usually via the femoral artery — and expanded inside the diseased valve, pushing it aside and taking over its function, without opening the chest or stopping the heart on bypass. Aortic stenosis means the outflow opening from the heart has narrowed, so the heart strains to push blood through it. Characteristic symptoms are breathlessness on exertion, chest pain or heaviness, and dizziness or fainting with exertion. The fact that governs the decision: **severe symptomatic stenosis is not a condition managed with medication** — no drug widens the valve, the real treatment is replacing it, and unjustified delay carries risk. The alternative is open surgical valve replacement. Choosing between them is not “newest is best” but a multidisciplinary heart-team decision (cardiology, cardiac surgery, anaesthesia, imaging) balancing age, surgical risk, comorbidities, valve and vascular anatomy, and expected prosthesis durability. The important point is that TAVI has become an option across a wide range of cases, but **not for every patient**, and some anatomy makes surgery more appropriate. Its main advantage is recovery far faster than open-chest surgery — many patients go home within a few days. The most important things to know beforehand: the possibility of needing a **permanent pacemaker** afterwards, because the new valve sits next to the heart’s conduction pathway; the need for antiplatelet or anticoagulant medication on a plan set by the physician; and lifelong echocardiographic follow-up.
Echocardiography measures stenosis severity and ventricular function alongside symptom assessment — the decision rests on severe symptomatic stenosis, not measurement alone.
CT of the valve, aorta and peripheral arteries sizes the required prosthesis, selects the access route and confirms the vessels can accommodate the delivery system.
The team weighs transcatheter versus open surgery by age, risk, comorbidities and anatomy, and the patient is told why the choice was made and what the alternatives are.
A sheath is placed in the artery and the folded valve advanced under fluoroscopy to position, then deployed, with its position, function and absence of paravalvular leak confirmed.
Cardiac rhythm is monitored for days to detect conduction disturbance that may require a permanent pacemaker, with a clear medication plan and lifelong echocardiographic follow-up.
Tell the team about all medications, especially **blood thinners and antiplatelets** (managed by plan — never stop them yourself), diabetes drugs, and any allergy to contrast or iodine. Report kidney disease, since contrast requires protective measures, and any previous cardiac surgery or existing pacemaker. Complete a dental check and treat any oral infection beforehand if asked, because oral infection poses a risk to valves. **Ask explicitly: why transcatheter rather than surgery in my case, what is my likelihood of needing a pacemaker, and what medication follows and for how long.** Observe the fasting instructions and arrange an escort and a short stay.
Care for and watch the access site: bleeding, increasing swelling, a pulsatile lump or severe pain warrants immediate contact. **Do not stop antiplatelet or anticoagulant medication on your own — not even before dental work or minor surgery; consult your cardiologist first.** Follow graded walking and the cardiac rehabilitation programme if prescribed. Maintain oral hygiene and routine dental review, and tell any dentist that you have a prosthetic valve. Attend lifelong periodic echocardiography appointments even without symptoms. **Attend emergency care immediately for increasing breathlessness, chest pain, fainting, severe dizziness, palpitations or a very slow pulse, or persistent fever and chills (which may indicate valve infection).**
One to two hours, with a hospital stay usually of two to four days
Dr. Munther Awni Al Saafin provides cardiology care at Jordan Hospital and Medical Centre. His interests include complex coronary intervention, chronic total co…
Dr. Qasem Al Shamaileh is a consultant in cardiology and interventional cardiology. His practice includes coronary and valve assessment, selection of appropriat…
Dr. Imad Al Haddad practices cardiology and interventional cardiovascular medicine at Jordan Hospital. His work includes complex coronary disease and assessment…
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