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Navigating MyCare
for Transcatheter Aortic Valve Implantation (TAVI)

The information in this guide will help you understand your transcatheter aortic valve implantation (TAVI) and your recovery. It also has information about what will happen on the day of your procedure and your care afterwards, including when you go home.

Not every journey is the same. Below we will take you through the general pathway patients go through when receiving TAVI.

Your care pathway

  • Before TAVI

    Information about preliminary appointments, diagnostic tests and assessments.

  • Your procedure

    Arriving at Sunnybrook, and general information about your procedure. 

  • During your stay

    What to expect during your stay, including medications you may take, and symptoms you may experience.

  • Leaving Sunnybrook

    Information about your transition plan for when it’s time to leave Sunnybrook.

1

Before TAVI

Is TAVI the best option for you?

TAVI is not for everyone. During your first clinic appointment, our aortic valve specialists will review your health history, your current health condition, and your medications. At this visit, you will also discuss the risks and benefits of receiving TAVI.

The Structural Heart Clinic will call you with the time of your first appointment. When you arrive at our Bayview Campus, go to A-wing, second floor, room A208.

Diagnostic tests

Blood testing and other diagnostic tests are needed to decide if TAVI is possible. These tests evaluate how your heart functions and its anatomy, such as the size and shape of your valve. Click on the test below for more information.

Pre-anesthesia assessment

If it is decided that TAVI is right for you, you will need to participate in a pre-anesthesia assessment to make sure you are fit and safe for TAVI. During the assessment, a nurse will ask you about your medical history, the medications you take, and will talk to you about any special needs you might have after your procedure. You may also meet with a pharmacist and the doctor (anesthesiologist) who will be giving you sedation (make you sleepy or relaxed) when you have a TAVI.

The pre-anesthesia clinic will phone you to tell you the date and time of your appointment. Check-in for your assessment at M-wing, ground floor, room MG402. Please eat and take all your regular medications before you come to this appointment.

Preparing your body and home

Maintaining a healthy lifestyle can help prepare your body for TAVI and help with your recovery after this procedure. Eat heart-healthy meals, follow a no-salt added diet and continue an easy, light exercise routine as advised by your TAVI team and cardiologist. Speak with your doctor, nurse or pharmacist about when to stop taking any prescription medication in preparation for your procedure.

During your recovery, you will not be allowed to lift over 2.3 kg (5 lbs) per arm, or 4.6 kg (10 lbs) total for at least 4 weeks. Arrange for someone to help you with daily tasks for the first several weeks after your procedure.

View more detailed instructions on preparing your body and home for TAVI.

2

Your procedure

Arrival

When you get to the hospital, check-in at the Outpatient Cath Lab area in the B-wing, 3rd floor, room B312.

After you check-in, you will be asked to put on a hospital gown and all of your personal clothing will be given to your family. A nurse will then bring you to a room to prepare you for TAVI. The nurse will sanitize your skin, clip any body hair, and carry out any orders from the interventional cardiologist.

Please do not bring any valuables – including (but not limited to) cash, jewellery, keys, electronics, and expensive clothing.

The procedure

The procedure takes approximately two hours. Following your procedure, you will be taken to the Cardiovascular Intensive Care Unit (CICU) or Short Stay Unit on the third floor of the B-wing for your recovery.

View more detailed information about your procedure.

3

During your stay

Getting moving

While you are in the hospital, you should increase your activity gradually to prevent you from losing muscle strength. At the beginning, you may be on bed rest. As soon as you are able, you will start with easy activities such as sitting in a chair and walking in your room.

Your health-care team will help you with activities while you are in hospital.

Wear closed-toe, rubber-sole slippers or shoes to keep you safe when walking.

Delirium

After TAVI, you may experience temporary changes to your thinking and behaviour. You may become disoriented, forgetful or have difficulty thinking clearly. This may be a result of being sedated during your procedure. Your health-care team will ask you questions to assess for signs of delirium and determine the best ways to help prevent or manage your condition.

For more information, visit sunnybrook.ca/delirium.

4

Leaving Sunnybrook

Day of your discharge

Most patients are able to go home the day after TAVI. You may stay in hospital a bit longer for monitoring. Your health-care team will keep you informed about when you are likely to leave.

Before being discharged, please arrange for someone to drive you home on the day of your discharge from the hospital. The planned discharge time is 11 a.m. (unless you’re told otherwise).

Medication

Changes may be made to your medications after your TAVI. New medications may be added for long-term heart protection, and you may be prescribed some temporary medications to help with pain or constipation after surgery. Some of your previous medication such as blood pressure medications, diabetes medications, or blood thinners may be adjusted or discontinued.

A new prescription will be given to you on the day that you are discharged – this prescription will be a complete list of all the medications you are to take when you go home. Consider filling your discharge prescription before leaving the hospital to avoid missing any medications. Our pharmacy is located in M1101 – M-wing, first floor – at our main entrance.

Cardiac rehabilitation program

There are cardiac rehabilitation programs across Ontario that are designed for people who are recovering from heart attacks, heart surgery or who are living with various heart and circulation conditions. The cardiologist/nurse practitioner will discuss rehab with you at your TAVI follow-up appointment, four to six weeks after your procedure. These programs are designed to improve your strength and the health of your heart.

Getting back to daily activities

During the recovery period, your body sees any activity as work. It is normal to feel more tired than usual. The goal is progressive activity – doing a little more each day. During the next four weeks, it is important to listen to your body. It will let you know when it needs rest, just as it will let you know when you feel energetic and able to begin or continue an activity.

For four weeks, do not lift items greater than 2.3 kilograms (five pounds) per arm, or 4.6 kg (10 lbs) total, for example: laundry baskets, groceries, telephone books, luggage, pets, children or infants. Do not push or pull heavy objects such as doors, furniture or appliances, or try to open stuck windows or jar lids.

Follow the home exercise program and progress tracker available in your My TAVI guide.

Follow-up appointments

The Structural Heart Clinic will call you to schedule your follow-up appointments. These appointments will be at four to six weeks and one year following your procedure.

Echocardiogram (Echo)

An echocardiogram (echo) is a test that uses ultrasonic sound waves to make pictures of the heart. They provide information on the size, shape and motion of various heart structures, such as heart valves, heart muscle, and blood flow.

An echo is a safe, painless test that takes approximately 45 minutes. While you are lying on a bed, a technician will apply some gel and a transducer (a plastic wand) to the left side of your chest. At times, the technician may press firmly on the transducer or ask you to hold your breath to help improve the quality of pictures.

Location: Your appointment will be in either E-wing or A-wing at our Bayview campus. The TAVI office will tell you the location of your appointment.

CT Gated Aorta (CT scan)

A CT scan is x-rays taken from different angles at the same time. A computer creates cross-sectional images – like slices in a loaf of bread – of your anatomy. The radiologist will measure your arteries from your groin through to your aortic valve, and all of your heart anatomy. This scan will help determine if your body will allow the aortic valve to travel up to your heart and implant safely.

For more information about your CT scan, including how to prepare, visit Sunnybrook.ca/medicalimaging

Location: Check-in for your appointment in A-wing at our Bayview campus, ground floor, room AG256.

Coronary Angiogram

A coronary angiogram is a minimally invasive procedure that uses a small tube (catheter) that is inserted into the artery in your groin or wrist. X-ray dye is injected into the catheter to look at your blood vessels (arteries or veins) that supply blood to your heart. The cardiologist will also measure the pressure inside the heart to determine how well your heart pumps blood. The procedure can take anywhere from 30 minutes to several hours depending on what your heart needs.

Location: Check-in for your appointment at our Outpatient Cath Lab our Bayview campus, B-wing, 3rd floor, room B312

After your diagnostic tests, the Structural Heart Clinic will call you for an appointment to discuss your test results.