TAVI - Dr Nicholas Aroney

A modern, less invasive option for aortic stenosis

Transcatheter Aortic Valve Implantation (TAVI), also called Transcatheter Aortic Valve Replacement (TAVR), is an advanced, minimally invasive procedure used to replace a narrowed aortic valve without open-heart surgery. It is particularly beneficial for older adults, patients with increased surgical risk, or anyone seeking a faster, gentler recovery.

Dr Nicholas Aroney is an interventional and structural cardiologist in Brisbane with extensive experience performing TAVI across major Queensland centres. He specialises in advanced coronary and structural interventions, including valve-in-valve procedures and complex anatomy. He trained at St Thomas’ Hospital London, a worldwide centre for TAVI excellence.

What Is Aortic Stenosis?

Aortic stenosis is a progressive narrowing of the aortic valve, restricting blood flow from the heart to the rest of the body.

Common symptoms include:

  • Shortness of breath

  • Chest pain or tightness

  • Fainting or dizziness

  • Fatigue and reduced exercise tolerance

  • Heart failure symptoms

Untreated severe aortic stenosis significantly increases the risk of heart failure and sudden cardiac death.

TAVI is now the preferred treatment for many patients.

What Is TAVI?

TAVI involves delivering a new aortic valve via a small catheter, usually through an artery in the leg (transfemoral approach). The new valve is expanded inside the old one, restoring normal blood flow.

Key benefits of TAVI

  • No open-heart surgery

  • No sternotomy

  • Most patients go home the next day

  • Rapid recovery and earlier return to activity

  • Proven outcomes equivalent to surgical valve replacement in many patients

  • Suitable for older adults or those with increased surgical risk

  • TAVI is performed under light sedation or general anaesthetic depending on clinical need.

Who Is Suitable for TAVI?

You may be a candidate for TAVI if you have:

  • Severe aortic stenosis

  • Symptoms such as breathlessness, chest pain, fainting or fatigue

  • Been told you are high or intermediate surgical risk

  • Frailty or other medical conditions making open surgery unsuitable

  • A previous surgical bioprosthetic valve that has degenerated (valve-in-valve TAVI)

  • Anatomy suitable for transfemoral or alternative access

Assessment includes:

  • CT angiography to evaluate the aorta, femoral arteries, valve dimensions and coronary height

  • Echocardiography

  • Consultation with the structural heart team

Dr Aroney performs comprehensive TAVI pre-planning focusing on annular sizing, coronary obstruction risk, valve selection, and procedural safety.

The TAVI Procedure: Step-by-Step

  1. Access through the femoral artery (most common approach)

  2. A catheter is advanced to the aortic valve

  3. The new valve (balloon-expandable or self-expanding) is positioned inside the old valve

  4. The valve is deployed and begins working immediately

  5. Patients typically walk the same day or next morning

  6. Most patients are discharged within 24–48 hours

Recovery After TAVI

Most patients experience rapid improvement within days.

Expected recovery timeline

  • Day 1: Walking, eating normally

  • Day 2: Most patients return home

  • 1 week: Light activity

  • 2–4 weeks: Full recovery

Follow-up includes echocardiography and clinical review.

Risks of TAVI

While TAVI is generally safe and highly effective, all medical procedures carry risks. These may include:

  • Vascular injury

  • Stroke

  • Pacemaker requirement

  • Paravalvular leak

  • Coronary obstruction (rare, but assessed carefully pre-procedure)

  • Bleeding or kidney injury

Dr Aroney uses advanced imaging, pre-planning and contemporary technologies to minimise these risks and ensure the safest possible outcome.

Valve-in-Valve TAVI

For patients with a failing surgical bioprosthetic aortic valve, valve-in-valve TAVI offers:

  • Faster recovery than redo cardiac surgery

  • Excellent haemodynamic improvement

  • Reduced procedural risk

Pre-procedural CT imaging determines suitability and identifies coronary obstruction risk, neo-LVOT size, and valve sizing.

Why Choose Dr Nicholas Aroney for TAVI?

  • Experienced interventional cardiologist specialising in coronary and structural heart interventions

  • Trained at a world renowned TAVI centre of excellence, St Thomas’ London

  • Thorough imaging-based assessment to optimise outcomes

  • Access to leading Brisbane hospitals and structural heart programs

  • Collaborative approach with cardiothoracic surgeons and the multidisciplinary team

  • Convenient clinic locations: North Lakes, Chermside and East Brisbane