Transcatheter Aortic Valve Replacement (TAVR)
Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure to treat aortic stenosis, a narrowing of the valve that regulates the flow of blood from the heart. This procedure is sometimes referred to as Transcatheter Aortic Valve Insertion, or TAVI.
Patients with advanced aortic stenosis causing symptoms such as fainting, chest pain, fatigue, shortness of breath, and lung congestion often require a procedure or surgery to replace the narrowed aortic valve. The TAVR procedure may only appropriate for patients who are not candidates for traditional open-heart valve surgery due to old age, frailty, and/or medical conditions such as lung or kidney disease that increase surgical risk.
Until TAVR became available, these inoperable patients could only receive medical therapy or a procedure that forced open the valve with a balloon (valvuloplasty). A large clinical trial called PARTNER showed that, compared to the standard treatments, TAVR greatly reduced the risk of death in these inoperable patients.
Keep in mind that patients with mild or moderate forms of aortic stenosis usually do not require surgery, and most patients with severe aortic stenosis will have traditional aortic valve replacement surgery because of its proven excellent results and safety. Again, only those patients who are inoperable or too high-risk for surgery may be eligible for TAVR.
At Temple, an interventional cardiologist, a cardiovascular surgeon, and other specialists will work together to determine if TAVR or another type of procedure or surgery is most appropriate for your condition.
The TAVR Procedure
In the TAVR procedure, a long flexible tube (catheter) is threaded through an artery to reach the faulty aortic valve. Once in position, a replacement valve at the tip of the catheter is expanded, pushing the natural valve aside. The artificial valve is made of animal tissue and metal mesh. Once secured in place, the new valve begins functioning immediately. TAVR is performed under general anesthesia in a hybrid operating room (suitable for traditional open surgery as well as catheter procedures).
Patients usually feel better immediately after valve replacement because of the improved blood flow. The PARTNER trial demonstrated improved survival after TAVR (compared to medical treatment alone).
The main risks of TAVR are catheter injury to the blood vessels, leaking of the valve after placement, and blood clotting that leads to stroke. Compared to traditional open surgery, minimally invasive TAVR has the advantages of not requiring cardiopulmonary bypass during the procedure and a shorter recovery (usually just 3-4 days in the hospital versus a week or more).
TAVR at Temple
At Temple, our cardiologists and surgeons have vast experience in traditional and advanced valve treatments. They specialize in helping patients with complicated conditions (such as a previously replaced surgical valve that leaks, or leg arteries that are too clogged for a catheter). They also have access to the latest types of artificial valves.
Because of our experience with all therapies for aortic stenosis, our team can work together to find the best options—whether TAVR or some other surgical or other option—for your specific condition.
To schedule an appointment with a Temple Heart and Vascular Center physician, click here or call 1-800-TEMPLE MED (1-800-836-7536).