Transcatheter Aortic Valve Replacement (TAVR)
Overview
What is a Transcatheter Aortic Valve Replacement?
Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure to replace a diseased aortic valve. The aortic valve controls the blood flow from your heart to your body. When the valve thickens and calcifies, it becomes stiff so your heart has to work too hard to pump blood. This is called aortic stenosis, which may lead to heart failure. During TAVR, a new valve is placed inside the diseased one without removing the old one. TAVR may be recommended if you have poor health or other medical conditions that make it too risky to replace your damaged valve during a more invasive open-heart surgery.
There are several TAVR procedures that your doctor may recommend depending on your overall health:
Transfemoral approach
Transfemoral approach is the most common procedure done, using the femoral artery in your groin.
Transapical approach
Transapical approach is a minimally invasive procedure done through an incision between your ribs.
Subclavian approach
Subclavian approach is done through a small incision in your shoulder with the catheter going into your subclavian artery.
Direct aortic approach
Direct aortic approach is done through a J-shaped incision at the top of your breastbone.
Your doctor will review with you the procedure recommended along with the benefits and risks so you can make an informed decision.
Why
Why a Transcatheter Aortic Valve Replacement?
TAVR is done to aortic stenosis that can cause chest pain, fainting, fatigue, shortness of breath and leg swelling that may lead to heart failure and sudden cardiac death.
Risks
Transcatheter Aortic Valve Replacement Potential Risks and Complications
The MOST COMMON risks for TAVR include:
- Damage to your blood vessels.
- Arrhythmia.
- Bleeding.
- Heart attack or stroke.
- Infection.
- Leaking of the replacement valve.
- Kidney failure.
- Fluid around your heart.
- Death.
Prep
Preparing for a Transcatheter Aortic Valve Replacement
Your doctor will give you specific instruction to prepare for your TAVR such as not eating or drinking midnight before the procedure as well as instruction about your current prescriptions. Your doctor may also order X-rays, CT scans or an echocardiogram to evaluate your aortic valve.
What to Expect
What to Expect During a Transcatheter Aortic Valve Replacement
Before your TAVR, your doctor will measure the aortic valve opening and then give you medicine to relax you or put you to sleep as well as medicine to prevent blood clots. Your doctor will then guide a catheter to your heart through the insertion point in your groin. The catheter has a folded replacement valve that your doctor will implant within the old, damaged valve. Once securely in place, your doctor will check for leaks or other complications before removing the catheter. You may have to spend a couple days resting in the hospital after the TAVR.
You will need to schedule an appointment, usually within a month, for a follow up check that the valve is working correctly and you are healing.
Specialists
