An aortic valve stenosis is the most common acquired heart valve disease. It usually occurs in advanced age, when the three half-moon-shaped valve cusps no longer open wide enough due to wear or calcification (sclerosis). Then the left ventricle must create clearly increased pressure in order to press the blood throough the narrowed valve.
As a consequence patients suffer from breathlessness, a narrowing sensation in the chest, loss of consciousness or acute heart weakness. Their life expectancy is significantly reduced. The only treatment is aortic valve replacement.

TAVI is performed without dividing the breastbone and without the heart-lung machine. The doctor first widens the valve using a balloon catheter. Next a folded new biological heart valve is carefully placed – also through the catheter – in the position of the old valve. The old valve is pressed against the wall and the new one unfolds in ist place, being anchored in the correct position by its wire scaffold.

The catheter is usually advanced through the body from a small incision in the groin, through the groin artery and to the heart (transfemoral access). If the groin artery is too small or the other arteries too calcified, the valve is introduced through the heart apex (transapical access). An incision a few centimeters long is made below the nipple, between the fifth and sixth rib. Behind that is the heart apex, through which the catheter can be introduced and the heart valve implanted.

The TAVI program at the German Heart Center Berlin is one of the largest in Germany. The procedures are always planned and performed by experienced cardiologists and heart surgeons working together in a “heart team”.
Two state-of-the-art so-called hybrid operation rooms are available for these procedures. They combine all the possibilities of a heart catheterization laboratory (for example, a mobile X-ray machine) with those of an operating room. Should complications arise, in the hybrid operation room surgical measures can immediately be taken.