Transcatheter Aortic Valve Implantation (TAVI)

Pre Test Procedures

1. You will have a 3-4 hour visit with a doctor and nurses in the CPAC prior to your procedure.
2. Once entering the Pre/Post Procedure area, you will change into a hospital gown.  It is suggested you give your belongings to your family to hold onto until after your TAVI.  Your family will be allowed to visit you here.
3. The nurse will ask you a few questions and help you onto a stretcher.
4. An intravenous will be started, and your groin area will be shaved and washed.
5. You will be given special mouth wash to prevent infection.
6. Before the TAVI, the doctor will review both the benefits and risks of the TAVI and have you read and sign a consent form agreeing to the TAVI procedure.

Test Procedures – 2 -3 hours 

1. You will be transferred to the TAVI room.
2. The anesthesiologist will give you medications to keep you relaxed and pain-free.  Some patients need a general anesthetic and breathing tube.  We will tell you if you will need either before starting your TAVI.
3. During the TAVI, your family is welcome to wait in the Y2 waiting room.  The doctor will come to speak to your family when the TAVI is complete.  

Post Test Procedures

Recovery in Intensive Care

1. You will be transferred to the Pre/Post Procedure area, and in some cases, the Intensive Care Cardiac Surgery (ICCS) or the Acute Cardiac Care Unit (ACCU).  
2. For the first four hours after the TAVI, a nurse will be checking your insertion site in your groin often and the head of your bed must be kept relatively flat.  The nurse will check you often.  Notify them of pain or discomfort.
3. Your leg must be kept straight for the first four hours after the TAVI to prevent bleeding.
4. When safe to do so, we will help you move around.  You will progress from sitting on the bed, to getting into a chair, and then walking in the hall. 
5. You will be given clear fluids initially, followed by increasing to your normal diet as drinking becomes normal.
6. The special monitoring equipment will be removed when you are ready to be transferred to the ward.

Recovery on the Ward

1. When you are ready, you will be transferred to Cardiology on the A Block, 5^th floor of the main hospital, or to the Cardiac Surgery Inpatient Unit (CSIU) on the 4^th floor of the Asper Centre.
2. While in the ward you will have some restrictions:
   • Do not lift, push or pull anything greater than 5 pounds for the first five days
   • Do not bend at the hips or sit for long periods of time (including bowel movements)
   • You will wear a heart monitor for 24-48 hours or until you are discharged home
   • Blood tests, chest X-rays, and other heart tests will be done as needed
   • The nurse will check your insertion sites often. You will learn what to watch for while your sites heal and we will teach you how to care for your sites at home
   • Notify the nurse or doctor if you notice the following: Bleeding from the site, a lump that is getting bigger, any area of redness or warmth that does not get better, yellow drainage from the insertion site, numbness in your leg, severe pain at the insertion site, or confusion, blurry vision or weakness

Arrangements 

• You need someone to drive you home after your TAVI.  You should plan to have someone stay with you for the first week after you leave the hospital.  

What to Bring/Not to Bring

• Bring a toothbrush and toothpaste, comb/brush.
• Bring slippers (with non-slip soles), glasses/hearing aids and reading material.
• Bring your walking aid, such as a cane or walker.
• Do not bring cash or valuables as the hospital is not responsible for the loss of any valuables.  

Mandatory Pre Test Measures

• Remain as active as possible, even if in short bouts.  Talk to your doctor about the best physical activity recommendations for you. 
• Eat a healthy diet to keep healthy for your TAVI.
• Take your medications as normally prescribed by your doctor.
• Ensure you see a dentist before your TAVI.  Make an appointment with your dentist if you have not had one in the last 6 months.  If you need teeth removed or treatment for gum disease, this must be done before the TAVI.
• Consider seeing other health care providers like a geriatrician, physiotherapist, dietitian or psychiatrist while you wait for your TAVI.
• On the day of TAVI:
  • Do not eat or drink anything after midnight the night before your TAVI
  • Take only the medications you were told by CPAC to take the morning of your TAVI with a sip of water