Being told that you may need TAVI can bring up a lot of questions. Why TAVI and not surgery? How experienced is the doctor? What are the risks? How long will recovery take? And what will the treatment cost?
Many patients search for the best TAVI surgeon or the best clinic for TAVR surgery in Mumbai, but experience and reputation are only part of the picture. You do not need to know everything about TAVI before meeting a specialist. But knowing what to ask can make the consultation easier and help you understand the choices in front of you.
Transcatheter Aortic Valve Implantation (TAVI), also known as TAVR, is a procedure used to replace a severely narrowed aortic valve. A replacement valve is guided to the heart through a thin tube called a catheter. In most cases, the catheter enters through an artery in the groin, where the upper thigh meets the lower abdomen.
This usually avoids the need to open the chest as in conventional heart surgery. TAVI is still a major heart procedure, though, and careful assessment and planning are important.
If the procedure is new to you, start by reading about how TAVI works and what happens during the procedure.
When choosing a TAVI specialist in Mumbai, these nine questions can help you have a more useful conversation about your treatment.
It is natural to ask how many years a doctor has been performing TAVI. But experience is not only about the number of years.
How often does the doctor perform the procedure? Do they treat people with more complex valve or blood-vessel problems? What experience does the hospital have with TAVI?
To understand the doctor’s experience, ask:
Hospitals may monitor outcomes such as stroke, bleeding, blood-vessel complications, pacemaker implantation, readmission and mortality.
Experience matters, but numbers alone cannot tell you how your own procedure will go. The experience of the wider team and the hospital’s ability to manage complications are also part of the picture.
Before your consultation, you can also learn more about TAVI specialists and programmes in Mumbai.
TAVI is not usually a decision made by one doctor in isolation. International guidelines support a Heart Team approach when patients are being considered for a heart valve procedure.
The team may include an interventional cardiologist, cardiac surgeon, cardiac imaging specialist and anaesthesiologist. Other specialists can be involved when needed.
Why does this matter? Because choosing between TAVI and surgery involves more than looking at one scan. Your symptoms, age, overall health, physical strength, valve anatomy, blood vessels and other heart problems can all influence the treatment plan.
Ask directly:
“Will my case be reviewed by a Heart Team?”
If you would like to know more about the people who may be involved in your care, read about the heart specialists involved in multidisciplinary heart care.
The choice between TAVI and surgery depends on your individual situation. Your age, overall health, physical strength, heart valve anatomy, blood vessels, surgical risk and whether you need another heart procedure can all influence the recommendation.
To understand why one approach is being recommended, ask:
These questions get to the part that matters most: why this treatment is being recommended in your case.
If you want to compare the approaches in more detail, read about alternatives to open-heart surgery for heart valve disease.
There is quite a bit of planning before TAVI. The tests give the Heart Team a closer look at your valve, heart and blood vessels and help them plan the procedure.
An echocardiogram, or heart ultrasound, shows how narrow the aortic valve is and how well the heart is pumping.
A CT scan provides detailed measurements of the valve and the blood vessels that may be used to reach the heart. You may also have an ECG to check your heart rhythm and blood tests to look at kidney function and other aspects of your health.
Some people need an assessment of the coronary arteries, which supply blood to the heart. The team may also assess frailty. Frailty looks at factors such as physical strength, mobility and how independently a person manages everyday activities. It can help the Heart Team understand how well someone may cope with and recover from treatment.
The exact tests will not be identical for every patient. If you are unsure why a test has been ordered, ask:
“What are you checking with this test, and could the result change the plan?”
For a closer look at what happens at this stage, read about tests and assessments before TAVI.
If you have been advised to consider TAVI and still have questions about your scans or treatment options, a Heart Team assessment can help you understand the recommendation.
Request a Heart Team Assessment
During TAVI, a replacement aortic valve is placed inside the narrowed valve. Replacement valves come in different types and sizes, so the team needs to choose one that fits your heart.
Measurements from your scans help with this decision. Your valve anatomy and longer-term heart-care needs can also be relevant.
Key points to clarify with the specialist include:
In most TAVI procedures, the replacement valve reaches the heart through an artery in the groin. If the blood vessels there are too narrow, heavily calcified or unsuitable for another reason, the team may consider a different route.
The important thing is that you know what is planned and why.
Reading a list of TAVI complications online can be unsettling. It also cannot tell you which risks matter most in your situation.
Possible complications include the following.
The level of risk is different for each person. Your age, physical strength, kidney function, heart rhythm, valve structure, blood vessels and other health conditions can all make a difference.
Rather than stopping at “Is TAVI safe?”, ask:
“What are the main risks in my case, and what will you do to reduce them?”
This gives you a clearer picture of the expected benefits and the risks that matter most in your situation.
The person performing TAVI is only one part of the team caring for you. The procedure also involves cardiac imaging, anaesthesia, nursing and monitoring. Intensive cardiac care, cardiac surgery, stroke care and other specialist services may be needed if a complication occurs.
It is worth knowing how the hospital handles that possibility.
Ask what would happen if there were a complication, whether cardiac surgical support is available when needed and where you will be monitored after the procedure. You can also find out who will keep your family updated and who to contact if you have a problem once you are home.
These are practical questions that help you understand how care is organised beyond the procedure itself.
How quickly will I be back on my feet? This is often one of the first things patients and families want to know.
Because TAVI does not usually require opening the chest, recovery can be quicker than after conventional open-heart surgery for many patients. Recovery time still varies from person to person.
Before going ahead, find out how long you are likely to stay in hospital and when you may be able to start walking. Ask how to look after the catheter-entry site, whether any medicines will change and when you can return to your usual activities.
It is also useful to know when your next heart check or scan will be and who to contact if you have concerns once you are home. Having these answers beforehand makes it easier for you and your family to plan the first few days and weeks.
For more information about what happens once the procedure is over, read the TAVI recovery and follow-up guide.
A price quoted for TAVI may include several parts of the treatment, so ask for a written estimate and look at what is actually covered.
This may include the replacement valve, hospital stay, doctors’ fees, anaesthesia, tests and scans, medicines, intensive care and follow-up.
For a more detailed breakdown, read about the TAVI procedure cost in India.
Before admission, it can help to check:
Cost is an important part of planning treatment, but it is only one part of choosing where to have TAVI. The experience of the team, hospital support and the treatment plan itself matter too.
If you have severe aortic stenosis and develop new or worsening chest pain, fainting, significant breathlessness or a sudden decline in what you can normally do, contact your healthcare team promptly. If symptoms are sudden or severe, or you feel seriously unwell, seek emergency medical care.
You do not have to walk into a consultation knowing every medical term. What matters is coming away with a clear idea of why TAVI is being recommended, what other options were considered and what the benefits and risks look like for you.
If an explanation does not make sense, ask for it in simpler words. Writing down your questions beforehand can help, and you may want to bring a family member with you. If you are still uncertain about a major treatment decision, getting another specialist opinion is also an option.
When choosing a TAVI specialist in Mumbai, experience and cost are worth asking about, but neither tells the whole story. You also want a team that takes your questions seriously, explains the choices clearly and plans treatment around your individual situation.
If TAVI has been recommended and you would like to discuss your diagnosis, treatment choices, risks or next steps, you can speak with a heart valve specialist.
TAVI is commonly performed by an interventional cardiologist with training and experience in structural heart procedures. The procedure involves a wider Heart Team rather than the cardiologist working alone.
Yes. You may want another opinion if you are uncertain about why TAVI has been recommended, want to compare it with surgery or simply want another specialist to review the proposed treatment before deciding.
TAVI usually does not require the chest to be opened. In most cases, the replacement valve reaches the heart through an artery in the groin. The treatment approach depends on the findings from your assessment.
They look at several factors together, including your symptoms, age, overall health, valve anatomy, blood vessels, surgical risk and whether another heart operation is needed.
TAVI can sometimes affect the heart’s electrical conduction system. If this causes certain persistent rhythm or conduction problems, a permanent pacemaker may be needed. Your specialist can discuss how this risk applies to your case.
About The Author
With over 15 years of expertise, Dr. Phatarpekar is recognised as a renowned interventional cardiologist in Mumbai, specialising in complex coronary interventions, structural heart procedures, and pioneering work in Transcatheter Aortic Valve Implantation (TAVI).
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