Transcatheter aortic valve replacement (TAVR) is a smart treatment option for people living with aortic stenosis (a narrowing of the aortic valve opening). Instead of performing open heart surgery, we can replace a heart valve while the heart is still beating using minimally invasive approaches rather than performing open heart surgery.
Heart care without open heart surgery
A healthy heart is made up of 4 valves that allow one-way blood flow to the rest of your body. When one of these valves is damaged, the heart can no longer pump blood effectively. The best way to restore the heart’s healthy rhythm is by completely replacing the valve with a prosthetic one. We can achieve this with a TAVR procedure.
TAVR is a type of interventional cardiology care — a medical specialty that treats heart and blood vessel conditions using very small incisions and catheters. With fewer incisions and a shorter required recovery time, we can help get your heart and life back on beat.
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Conditions
The aortic valve connects to the aorta and the left ventricle, which is the body's main pumping chamber that delivers blood to the rest of the body. For people with aortic stenosis, calcium builds up in the valve over time to the point where the valve becomes very tight or may not open at all. This can lead to symptoms like:
- Chest pain
- Fainting or feeling lightheaded
- Fatigue
- Shortness of breath
The best way to treat this condition is by replacing the heart valve. That’s where TAVR comes into the mix as a lifesaving procedure that delivers a new heart valve using very small incisions.
Additionally, people living with aortic valve disease may benefit from TAVR to restore healthy heart function.
Who's a candidate for TAVR?
People who undergo the TAVR procedure are oftentimes over age 30. Currently, there are 3 groups of people who would benefit from TAVR:
- People who are at exceptionally high risk for surgical aortic valve replacement.
- People who are believed to be at high risk for surgical aortic valve replacement.
- People who are believed to be at intermediate risk for surgical aortic valve replacement.
Testing
You’ll meet with a handful of experts during your initial consultation, including a:
- Cardiac surgeon
- Interventional cardiologist
- Nurse practitioner
- Valve specialist
Undergoing TAVR is not something you have to bear the weight of alone. One of the most meaningful parts of the evaluation is having you and your loved ones meet with your care team. You can count on us to keep your primary care doctor and cardiologist involved in the process every step of the way.
Treatments
While the gold standard for treating aortic stenosis is with surgical aortic valve replacement (open heart surgery), TAVR is a smart and effective alternative for people who cannot undergo complex surgery.
Approaches to TAVR
Once we confirm that you’re a candidate for TAVR, we’ll pinpoint what approach to take.
Transfemoral approach
Known as the gold standard access route for the TAVR procedure, this catheter-based approach involves making a small incision in the groin area to access the femoral artery. Using an imaging device like an X-ray or ultrasound, the doctor threads the catheter through the vein and places the valve in the aorta. Around 80% of people are candidates for this approach.
Transaortic approach
We make a small incision under the collar bone, where we’ll use a small artery to thread and place the valve in the aorta.
Transapical approach
We make a small incision in the front of the chest in the upper sternum, where we place the valve directly in the aorta.
What to expect during the TAVR procedure
We’ll perform the TAVR procedure in our hybrid operating room. It’s here that we combine the techniques of a cardiac surgeon and the technology of a catheterization laboratory (cath lab).
- Preparing for surgery: To kick off the 2-hour long procedure, we'll place you under general anesthesia so you'll be in a comfortable sleep the entire time.
- Accessing the heart: Your doctor will make a small incision to access a blood vessel (location depends on your TAVR approach). Using imaging technology for guidance, the catheter is carefully threaded through the blood vessel and up to the heart.
- Placing the prosthetic valve: Using the catheter, your doctor feeds the prosthetic valve up to the heart where it then expands to push the diseased valve out of the way, effectively taking over its placement and job of regulating blood flow.
- Removing the catheter: We'll monitor your heart to ensure the heart valve is properly working before removing the catheter and closing the incision.
- Recovery: You’ll move to the post-anesthesia care unit where you’ll awake from the anesthesia. Most people remain in our hospital care for about 2 days before returning home. It’s important to relax and rest once you’re home. The good news is that you’ll start to feel normal again within 2–3 weeks.
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