Transcatheter Aortic Valve Replacement
Transcatheter aortic valve replacement (TAVR) isn’t just an alternative to open heart surgery. It has become the mainstay of treatment for severe aortic stenosis (narrowing of the aortic valve that obstructs blood flow from the heart to the rest of the body). Like surgical aortic valve replacement, TAVR has been shown to consistently lengthen patients’ lives and improve their quality of life. It is a less invasive procedure (typically performed without making incisions on the chest) in that the diseased aortic valve is replaced via a catheter without stopping the heart. Initially, TAVR was an alternative option primarily for those who could not undergo open heart surgery or were at high risk for poor postsurgical outcomes. Patient eligibility has expanded, but the procedure still is not for everyone. LifeBridge Health’s heart care team, comprised of board-certified cardiologists and cardiac surgeons, will perform a thorough evaluation to determine if you are a candidate. We have successfully performed hundreds of TAVR procedures, with multiple outcome measures in the top decile.
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Am I candidate for TAVR?
TAVR currently is approved by the Food and Drug Administration (FDA) for people with severe symptomatic aortic stenosis.
Common symptoms of this condition include:
- pain, discomfort or tightness in the chest that worsens during exercise
- shortness of breath (or feeling overly tired)
- fainting spells, dizziness or lightheadedness
- heart palpitations (heart skips a beat or flip-flops in your chest)
Our TAVR team collaboratively conducts comprehensive assessments for each patient to determine if the procedure is appropriate for them. Your assessment may include:
- a consult with a cardiac surgeon for a review of your health history to help determine the best treatment, be it TAVR, traditional surgery or medication
- a consult with an interventional cardiologist
- a medical checkup
- a review of certain factors pertaining to your everyday life (to include questions about your mobility and family support during recovery) for a more complete picture of your health and eligibility
- an opportunity for you and your family to ask questions about your care and treatment options
- tests such as: cardiac catheterization (a minimally invasive way to diagnose and treat various heart and vascular conditions by guiding thin, flexible tubes through the blood vessels to problem areas), chest X-rays, a computerized tomography (CT) scan, an echocardiogram, an electrocardiogram (ECG), blood work and a dental exam
What can I expect during the procedure?
You may receive local or general anesthesia before the procedure begins. Your doctor will make a small incision in your groin and insert a catheter (a thin, flexible tube) into a blood vessel. The doctor will then guide the catheter through the artery to the aortic valve. When it is in position, the balloon will inflate and the new valve will expand, pushing the damaged valve out of the way and leaving the old valve in place. The doctor will then remove the catheter.
The new valve will act as a brace that stays open permanently, restoring healthy blood flow. Once the procedure is done, the insertion site is closed. You will then be taken to the recovery area for close monitoring of your vitals. Bed rest lasts until the introducer (tube) is removed, which can take 4 to 12 hours.
What can I expect after the procedure?
The procedure lasts 90 minutes to two hours and typically requires a one- to two-day hospital stay. Unlike during open heart surgery, your breastbone will not be broken.
Most patients can resume their normal activities soon after they leave the hospital. You may need to take blood-thinning medications to prevent blood clots.
There is an expectation of follow-up appointments:
- two weeks post-procedure (at which point you should see your primary cardiologist)
- two to four weeks post-procedure (at which point you should see your primary care doctor)
At around 30 days post-procedure, you will have an appointment with our multidisciplinary valve clinic team, during which you will have an echocardiogram and answer questions about your recovery.
Studies have shown that patients achieve better outcomes when they undergo TAVR than they do with medication alone. Specifically, they experience:
- faster recovery time
- less pain
- less trauma to the body
- reduced blood loss
- reduced risk of infection
- smaller, less-noticeable scars