TAVI Specialist in Mumbai

When Do You Need a TAVI Procedure?

 

You would need a TAVI procedure if you have severe symptomatic aortic stenosis that’s drastically limiting your daily life, where your heart team believes that risks of open heart aortic valve surgery outweigh the benefits. Severe Aortic Stenosis (AS) occurs when the aortic valve, the main entrance to the heart, becomes narrowed by thickening and the formation of calcium, making it difficult for blood to flow out of the heart and into your body. You could be experiencing difficulty breathing while doing simple things like walking, chest pain or discomfort (angina), unusual fatigue, dizziness, fainting spells, or a rapid or irregular heartbeat (palpitations).

 

Key triggers:

 

A severe aortic stenosis is characterized by a reduction in valve opening size (area less than 1 cm² and gradient more than 40 mmHg on echo). This leads to classic symptoms like breathlessness on exertion, chest pain, blackouts, and potential heart failure. TAVI should be considered if symptoms persist despite medication and if you are symptomatic (NYHA class II-IV).

 

Risk-based decision-making:

As mentioned earlier, TAVI is considered if you aren’t eligible for a traditional open-heart surgery — usually the first line of intervention, in severe aortic stenosis. Personalised risk profiling is done using stratification tools like STS or EUROscore, which factor in patient history, genetic data and comorbidities to provide a potential risk score and insight into peri-operative and post-operative outcomes:

• High/Prohibitive risk: Frail, elderly patients (>75-80 years), STS risk > 8%, previous thoracic surgery, pulmonary or renal disease, or ‘porcelain aorta’ (very highly calcified and hardened aorta, which could ‘crack’ upon operation). TAVI is the first choice in such patient profiles.
• Intermediate Risk: STS risk of 4-8%. Shared decision-making. Here, it often comes down to what the entire team agrees upon and a careful evaluation of post-surgical/procedural benefits to the patient.
• Low Risk: STS risk <4% risk. Now approved per trials, especially with favorable anatomy for transfemoral approach. Surgery can be avoided, thus improving recovery time and reducing infection risk.

 

Evaluation process:

Tests confirm: Echo/CT for valve size/anatomy, frailty scores, and life expectancy >1 year. In India, earlier onset (age 60-70) from degeneration/bicuspid valves prompts TAVI in ~2.5 lakh eligible patients, often with diabetes/comorbidities raising surgical risks.

 

Why opt for a TAVI procedure in Mumbai:

 

When deciding on a city to have a procedure, the most crucial factor is the volume of cases and expertise within that city. Mumbai deals with an extremely large number of AS cases and TAVI procedures are conducted on very complex cases regularly. As a city, the procedure volume and variation is extremely high.

 

Due to the number of world-class super speciality hospitals and expert cardiac teams, success rates are very high — comparable to global standards, by every benchmark. Most leading hospitals perform hundreds of TAVIs each year, with the latest technology like Philips Aurizon cath labs and hybrid ORs. Additionally, Mumbai has a high usage of indigenous valves (for E.g., MyVal) which are better suited to Indian coronary anatomy.

 

Cost of a TAVI procedure in Mumbai:

TAVI procedures in Indian hospitals cost anywhere between ₹ 15 - 36 lakh varying by valve type (Indian or imported), hospital, ICU stay duration and type of ward.

 

Key factors affecting price:

• Valve type: Procedures with Indian valves like MyVal cost between ₹ 12-20 lakh; the use of imported valves (for E.g., Sapien) adds approximately ₹10 lakh to the overall cost.
• Surgical approach: The standard approach for catheterization is transfemoral. When the femoral arteries are too small, calcified, tortuous or diseased (seen in 5-15% of cases), other approaches are used. These raise costs by 10-20% due to surgical expertise required and general anesthesia needs.
• Cath lab type: High-end cath labs like the Azurion 7 M12 are used to provide precise imaging for TAVI procedures, helping to reduce procedural time/risk using 3D fusion and low radiation. While this doesn’t impact cost on a case-by-case basis, it does affect the hospital baseline, as it allows for high-volume surgical expertise.

 

Why Mumbai shines for advanced heart procedures like TAVI:

 

Mumbai has a long history of firsts, in the cardiovascular space. If you’re facing a complex issue like aortic stenosis, Mumbai is an incredible choice for treatment. It has the highest per-hospital volume of TAVI procedures in the country. This means, any of the top cardiac institutes average more procedures per year than those in many parts of the country.

 

Mumbai’s hospitals also have a strong minimally invasive focus. This shows in national surveys, which clearly indicate that Mumbai shines in patient recovery speed and shorter hospital stay durations. The average hospital stay, as per reports from hospitals, is 3-5 days. This suits frail and elderly patients, in particular.

 

Mumbai also leads with tech adoption — in particular Philips Azurion cath labs featuring ceiling mounted, large 20-inch detectors for superior 3D/4D imaging and low radiation. This tech minimizes leaks or malpositioning, thereby driving faster recovery times.

 

Hybrid ORs with 3D echo are standard in Mumbai, which make non-femoral access far easier. In particular Mumbai excels in its density of integrated hybrid cath labs — enabling seamless switching from procedures like TAVI to open surgery in one room — reducing patient transfers, OR time and risks. For urgent and escalating cases, this is a key advantage.

 

Areas in Mumbai we serve:

 

HVS superspeciality hospitals offer TAVI procedures at four different branches — Dadar, Ghatkopar and Thane,. Our Ghatkopar and Thane centers are highly-accessible centers in patient-dense areas, emphasizing the pragmatic aspect of minimally invasive care closer to home.

 

How to select a hospital and doctor for your TAVI procedure:

• Choosing a hospital and doctor for your TAVI procedure involves weighing a few core factors — expertise, technology, volume and outcome, and logistics.
• Most importantly, prioritize higher volume TAVI centers (>50 TAVIs/year), for better outcomes.
• For doctors, check the lifetime procedure volume (>100 TAVIs), reviews and outcome, familiarity with complex cases and whether they train other doctors.

 

Hospitals — Checklist

Factor	What to Check
Volume/Experience	>100 TAVIs; heart team credentials and fellowships
Technology	Azurion cath labs, hybrid ORs
Accreditation	NABH/JCI
Cost	₹15-36 lakhs, insurance coverage, valve type, etc.
Location/Access	Parking, family stay, ward type

 

Doctors — Checklist

Factor	What to Check
TAVI Cases	Lifetime volume > 100 TAVI cases
Proctor/Faculty	Trains others
Reviews/Outcomes	95%+ success, short stays, complex patient profiles
Multidisciplinary	Works with cardiac surgeons