Teknik Transcatheter Aortic Valve Implantation (TAVI)

Oleh :

dr.Nailla Fariq Alfiani

Teknik transcatheter aortic valve implantation (TAVI) melibatkan prosedur minimal invasif untuk mengganti katup aorta yang mengalami stenosis berat dengan menggunakan katup prostetik yang dipasang melalui kateter tanpa pembedahan terbuka. Prosedur ini umumnya dilakukan melalui akses vaskular transfemoral, meskipun rute alternatif seperti transapikal atau transaorta dapat digunakan bila akses femoral tidak memungkinkan.

Setelah pemasangan sheath vaskular, kateter pemandu diarahkan ke katup aorta di bawah panduan fluoroskopi dan ekokardiografi. Katup prostetik diposisikan di dalam katup aorta yang stenotik dan dilepaskan, sehingga mendorong daun katup asli ke perifer dan memungkinkan fungsi katup baru. Setelah implantasi, dilakukan evaluasi hemodinamik dan pencitraan untuk memastikan posisi katup optimal, serta tidak adanya komplikasi seperti regurgitasi.[13,14]

Persiapan Pasien

Referensi

2. Monteiro, J. P., Brugaletta, S., Freixa, X., Regueiro, A., Rijo, D., & Sabaté, M. The roadmap to transcatheter aortic valve implantation. Revista Portuguesa de Cardiologia, 42(9), 733–739. (2023). https://doi.org/10.1016/j.repc.2022.09.004
4. Webb, J. G., Blanke, P., Akodad, M., et al. TAVI in 2022: remaining issues and future direction. Archives of Cardiovascular Diseases, 115 (4), 235–242. (2022). https://doi.org/10.1016/j.acvd.2022.04.001
5. Rahman, F., & Resar, J. R. TAVI Beyond 3 Years: Durability and Predictors for Survival. Innovations (Philadelphia, Pa.), 16(5), 417–425. (2021). https://doi.org/10.1177/15569845211017558
6. Otto, C. M., et al. 2022 ACC/AHA guideline for the management of patients with valvular heart disease. Nature Reviews Cardiology, 19, 587–589. (2022). https://doi.org/10.1038/s41569-022-00734-5
7. Windecker, S., et al. Heart Team decision-making and patient-centered indications for TAVI. Netherlands Heart Journal, 31, 563–572. (2023). https://doi.org/10.1007/s12471-023-01811-1
9. Reardon, M. J., et al. Clinical outcomes and patient selection for transcatheter aortic valve implantation. Journal of the American Heart Association, 12, e033768. (2023). https://doi.org/10.1161/JAHA.123.033768
11. Vahanian, A., Beyersdorf, F., Praz, F., Milojevic, M., Baldus, S., Bauersachs, J.et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease. European Heart Journal, 43(7), 561–632. (2022). https://doi.org/10.1093/eurheartj/ehab395
12. Varghese, J. J., & Maniar, H. S. Transcatheter aortic valve replacement. In StatPearls. Treasure Island (FL): StatPearls Publishing. (2024). https://www.ncbi.nlm.nih.gov/books/NBK537273/
13. Parma, R., Joner, M., Saia, F., Cuisset, T., Delgado, V., et al. Procedural and clinical outcomes of patients undergoing a TAVI in TAVI procedure: Rationale and design of the multicentre, prospective, observational ReTAVI registry. European Journal of Clinical Investigation, 54(9), e14241. (2024). https://doi.org/10.1111/eci.14241
14. Aris, A., Mansouri, A., Dehghan, H., Tabesh, F., Amini, M., & Khosravi Farsani, A. Early experience of transcatheter aortic valve implantation (TAVI) procedure in Isfahan, Iran. ARYA Atherosclerosis, 21(2), 18–27. (2025). https://doi.org/10.48305/arya.2025.43010.2995
15. Nechwatal, R. M., Bestehorn, K., Leuschner, F., Hagendorff, A., Guha, M., & Schlitt, A. Nachsorge nach kathetergestütztem perkutanen Aortenklappenersatz (TAVI) [Postacute care after transcatheter aortic valve implantation (TAVI)]. Herz, 46(Suppl 1), 41–47. (2021). https://doi.org/10.1007/s00059-020-04915-1
16. Stamate, T. C., Adam, C. A., Gavril, R. S., Miftode, R. Ș., et al. Cardiac rehabilitation in TAVI patients: Safety and benefits: A narrative review. Medicina (Kaunas, Lithuania), 61(4), 648. (2025). https://doi.org/10.3390/medicina61040648
17. Tagliari, A. P., Petersen Saadi, R., Medronha, E. F., & Keller Saadi, E. (2021). The Use of BASILICA Technique to Prevent Coronary Obstruction in a TAVI-TAVI Procedure. Journal of clinical medicine, 10(23), 5534. https://doi.org/10.3390/jcm10235534
18. Harloff, M. T., Percy, E. D., Hirji, S. A., Yazdchi, F., Shim, H., Chowdhury, M., Malarczyk, A. A., Sobieszczyk, P. S., Sabe, A. A., Shah, P. B., & Kaneko, T. A step-by-step guide to trans-axillary transcatheter aortic valve replacement. Annals of cardiothoracic surgery, 9(6), 510–521. (2020). https://doi.org/10.21037/acs-2020-av-79
19. Van Praet, K. M., Nersesian, G., & Kukucka, M. Standard Transfemoral Transcatheter Aortic Valve Replacement (Case Report No. 1754). Multimedia Manual of Cardiothoracic Surgery. Oxford University Press. (2022). https://mmcts.org/case-report/1754

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Teknik Transcatheter Aortic Valve Implantation (TAVI)

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