What Is TAVR?
TAVR is a minimally invasive procedure used to treat aortic stenosis (narrowing of the aortic valve opening). Aortic stenosis slows down blood flow from the left ventricle to the aorta and may also affect the pressure in other parts of your heart. This may cause shortness of breath, extreme fatigue, or other symptoms.
Aortic Stenosis
Aortic stenosis may be a congenital defect but is more commonly caused by calcium buildup in older adults. Over time, calcium and minerals can deposit on the aortic valve’s leaflets. These leaflets are flaps of tissue that open and close, regulating the flow of blood through your aortic valve.
TAVR restores proper blood circulation by inserting a replacement valve into the damaged valve via a catheter-based procedure.
What Does TAVR Stand for?
TAVR stands for transcatheter aortic valve replacement (TAVR).
Who Qualifies for TAVR Procedure?
You and your doctor will consult with a team of medical and surgical specialists to determine your best treatment options.
TAVR can increase the chance of survival and is an effective choice for people considered at high risk of complications from traditional aortic valve replacement procedure, or those who can’t undergo open-heart procedures.
Often, we recommend TAVR for patients who are in their 70s or 80s, may be frail, or have additional medical conditions which make them a better candidate for this type of procedure.
TAVR Procedure
During the TAVR procedure, your damaged heart valve is replaced with a natural-tissue valve from the heart of a pig or cow. This is also called a biological tissue valve. The new valve is supported with a metal frame (stent).
In some cases, TAVR may replace an existing biological tissue valve from a previous operation.
Available TAVR Valves
The University of Utah Health team uses the FDA approved TAVR valves, Edwards Sapien S3(R) (balloon expandable), and Medtronic Evolut Valve(R) (self expandable). Your heart team will discuss differences and benefits of the valve they recommend before your procedure.
How Is TAVR Different From a Standard Valve Replacement Procedure?
Most valve replacement procedures require an open-heart surgery, in which chest bones are separated in order to access the heart. TAVR procedures are done through plastic tube via blood vessels that connect to the heart, leaving all chest bones in place.
Although types of valve replacement vary, TAVR does not require traditional anticoagulation or blood thinners like mechanical heart valves.
Find a Heart Team Specialist
What to Expect During TAVR Procedure
You and your treatment team will discuss specifics of your procedure, including the best way to prepare, what you may be able to eat or drink, and appropriate medications.
If your specialist and you decide on TAVR, our treatment team provides anesthesia before the procedure begins, causing you to sleep deeply and painlessly during the operation. You won’t remember the operation.
Your body continues to breathe and circulate blood normally. Your vital signs are continuously monitored throughout the procedure.
First, your surgeon and cardiologist will access your heart valve using one of two different approaches, based on individual patient’s anatomy and safety.
Transfemoral Approach
Your surgeon/cardiologist will enter through the femoral artery in your leg. This approach does not require a chest incision.
Alternative Approaches
Although we prefer to enter through the femoral artery, sometimes those arteries aren’t the best choice. Your heart team may access your heart through other ways, including:
- subclavian arteries (this is the artery near your shoulder which can also be used to perform TAVR procedure),
- suprasternal access (through small incision above your chest bone), and
- transapical (through a tiny incision in your chest, reaching your heart through a large artery or through the tip of the bottom left chamber of your heart (left ventricle).
Specialists perform the TAVR procedure using a hollow tube (catheter) inserted through the access point. Your heart team uses advanced imaging to guide the catheter through your blood vessels to your heart and into your aortic valve.
Once the catheter reaches a precise position, we deliver the new valve through the catheter to press the replacement valve into the damaged valve.
After your team makes sure the new valve is securely placed, they remove the catheter from your blood vessel or the incision in your chest.
The new valve now opens and closes, guiding blood to flow in the correct direction.
How Long Does a TAVR Procedure Take?
The TAVR procedure usually takes one to three hours.
TAVR Procedure Recovery
Following your procedure, you will be taken to a recovery room, and then to the monitor bed or intensive care unit (if needed), before moving to a private room. Your recovery team will closely monitor your vital signs and medication. You may have an IV in your arm to administer medication.
Your doctor may prescribe blood-thinning medications to prevent blood clots after the procedure. Your doctor will discuss with you how long you may need to take these medications.
You can sit up and walk, eat solid food, and visit with family within eight to 12 hours.
The typical hospital stay is one to two days.
What to Expect After TAVR Surgery
It’s important to discuss follow up care with your doctor.
Your doctor and nurses will give you specific instructions on:
- how to care for your incision site,
- what medications to take, and
- other physical therapy or general recommendations.
Most patients are scheduled to check in with their doctor seven to 10 days after leaving the hospital. You will typically have a follow up visit with your cardiologist within a month, and additional EKGs at three months, six months, and one year after the operation.
With your doctor’s approval, you’ll return to normal activity in about a week.
Results & Outcomes for TAVR Procedure
Most patients see improvements and remain symptom free years after their TAVR procedure. Our data have suggested that the valve continues to function beyond five years.
Your individual outcomes may vary based on your overall health and lifestyle. You and your doctor will set up a plan to keep you healthy. This may include medication, regular exercise, dietary changes, or other positive habits.
Hear From Our Patients
Kirby Barker is no stranger to heart surgery. At the age of 56, he’d already undergone two open-heart operations to replace his aortic valves, stemming from chronic heart conditions. But Kirby came to University of Utah Health for something he couldn’t find anywhere else. a diverse team of skilled specialists collaborate to provide an unprecedented standard of truly personalized care.
For Kirby and his wife, Ruth, these specialists became known as the Kirby Barker Heart Dream Team, performing back-to-back heart valve replacement procedures with remarkable results.
I’m Ready to Get Going! TAVR Procedure Helps Patient Maintain the Active Lifestyle that He Loves
Martin’s keen awareness of his body and a gnawing feeling that something wasn’t right led him to visit with a local cardiologist. Just weeks later, Martin lost consciousness during a moderate bike ride. A bystander rushed to Martin’s aid and helped him recover his breath and stability. Martin had suffered a heart attack in 2012 due to coronary artery disease.
After Six Years of Living with Mechanical Heart Pump, Patient Receives the Ultimate Gift
Stephen Love suffered a massive heart attack in 2016. The incident left him severely injured with poor odds for survival and an uncertain future. After two weeks on various mechanical circulatory support devices, Love's cardiac team assessed him to see if he could benefit from the implantation of a left ventricular assist device (LVAD).
