Talking TAVI: A Surgery in the Spotlight.

In June 2025, a number of news outlets began reporting on investigations into the deaths of several patients at an NHS Trust following a heart procedure called a, ‘TAVI’. This procedure is often treated as a less invasive alternative to traditional heart surgery and has been associated with very positive recovery and outcomes.

However, this is not always the case as recent coverage has shown. What then is a TAVI, what are the benefits and risks, and why is this procedure being reported in the news?

A TAVI stands for a Transcatheter Aortic Valve Implant. It is a procedure where an artificial valve is used to replace a damaged or poorly functioning aortic heart valve; a condition called aortic stenosis (a narrowing of the heart valve).

What makes the procedure unique is that as opposed to traditional open heart surgery, the valve is replaced using a catheter passed up through either the leg or chest via a large blood vessel towards the heart. It is often a procedure used for patients who may not be suitable for open heart surgery, perhaps due to having too high a risk of death, but its use outside of these cases is understood to be becoming more common.

Based on data from the National Cardiac Audit Programme (NCAP), there are 32 NHS TAVI centres across England, Wales and Northern Ireland, with the number of urgent procedures using the technique increasing across the country. The procedure is largely performed under a local anaesthetic with the average admission to hospital being two days.

It is generally considered that a TAVI procedure has a low mortality rate, with data released by the National Cardiac Audit Programme (NCAP) indicating that in 2023/2024 the in-hospital mortality rate was on average 0.8%. However, it is notable that the mortality for urgent cases, of which there is a noted increase, is 1.6%. TAVI procedures do have an association with a need for a permanent pacemaker, with 7.7% of patients requiring one, usually after the TAVI procedure itself.

What can be drawn from the data on the TAVI procedure is that whilst it is an alternative treatment pathway, and on the surface appears to be a less drastic surgical procedure with a shorter envisaged recovery time, there remains a risk of severe, and possibly fatal, complications and there is also a need for scrutiny by a multi-disciplinary team with specialist experience in this procedure. Without it, there is a risk of serious consequences.

The most recent coverage extends to incidents at an NHS Trust with a rate of fatalities three times above the national average, poor performance in the cardiac unit, and reported transparency concerns about the TAVI procedure itself. This is not the first time the TAVI procedure has been subject to news coverage. In 2020, it was reported that a Welsh Health Board was criticised for unsatisfactory assessments of patients undergoing a TAVI procedure. The recent news coverage once again highlights the importance of ensuring all procedures, particularly in areas involving complex comorbidity patients, are assessed properly, the procedure explained correctly, as well as the material risks sufficiently documented and communicated to the patient. It reminds everyone that the patient must be kept at the centre of the discussion and their patient autonomy protected.

If you wish to speak to Lanyon Bowdler’s specialist Clinical Negligence Team, please email info@lblaw.co.uk or phone 0800 652 3371.