TAVR

Your cardiologist and/or cardiovascular surgeon have determined that you have severe aortic stenosis and need to have the aortic valve in your heart replaced. Your treatment options for this condition include a minimally invasive procedure called the Transcatheter Aortic Valve Replacement (TAVR). Below is information about how your heart works, aortic stenosis, and the TAVR procedure. Talk with your physician to see if the TAVR procedure is an option for you.

The aorta is a major blood vessel within the heart that delivers blood to the rest of the body. Aortic stenosis is a narrowing of the aortic valve opening which prevents normal blood flow from the left ventricle to the aorta causing the leaflets to not open and close properly. This restriction of the aortic valve makes your heart work harder to get the blood pumped to the rest of your body.

Aortic stenosis mainly affects older people due to scarring and calcium buildup in the valve leaflet. Birth defects, radiation therapy and rheumatic fever may also cause aortic stenosis. The disease process is not preventable, but it can be treated.

Symptoms of aortic stenosis include:

• Chest pain or tightness
• Fatigue
• Shortness of breath
• Dizziness
• Irregular heartbeat
• Swollen feet or ankles

There are several types of surgical procedures which can be used to treat severe aortic stenosis which involves replacement of the damaged aortic valve. 

Open heart surgery is one treatment option. The damaged valve is surgically removed and the new valve is inserted through a chest incision. The patient is on a heart-lung bypass machine during the procedure. Some patients are at high risk due to illness or other conditions and may not be a good candidate for open heart surgery.

Minimally invasive open heart surgery is similar to open heart surgery, but a smaller incision in the chest is needed. The surgeon uses a tiny camera and small tools to replace the aortic valve. For those who cannot have open heart surgery, this is an option for treatment.

Transcatheter Aortic Valve Replacement (TAVR) is an alternative treatment option for those patients who are at high risk for open heart surgery and qualify for the procedure. While the heart is still beating, TAVR allows a new valve to be placed inside the diseased aortic valve via a thin, flexible tube, or catheter. The new valve replaces the diseased valve and blood flow is increased throughout the body. The patient does not have to be on a heart-lung bypass machine during TAVR.

Patients who undergo a TAVR procedure generally have a shorter recovery time to resume everyday activities since it is less invasive. The entire TAVR procedure generally takes two to three hours.

Hospitals that offer TAVR are required to have a specially trained heart team. The team at St. Francis Medical Center will include a cardiac surgeon, an interventional cardiologist, imaging specialists, nurse practitioners or physician assistants, coordinators, and others. This team will evaluate your condition and determine the best TAVR procedure for you.

There are three types of TAVR procedures, all of which use a type of X-ray for catheter guidance and valve delivery:

• Transfemoral – the aortic valve is delivered to your heart through a catheter inserted through a small incision in your leg.
• Trans-subclavian – in this procedure, the aortic valve is delivered through an incision in the top of your chest, under your collar bone. It can be delivered through the right or left side.
• Transaortic – with this approach, the valve is delivered through an incision in the front of your chest between your ribs.