What is Transcatheter Aortic Valve Replacement (TAVR)?
Transcatheter aortic valve replacement is a minimally invasive surgical procedure for the treatment of severe aortic stenosis. It can be a better alternative for patients who are determined as high risk for traditional open heart surgery.
Aortic stenosis is a serious condition affecting more than a million Americans. There are several causes, including birth defect, rheumatic fever, endocarditis, radiation therapy, and age. As we get older, calcium/mineral deposits can build up on the aortic valve causing them to become stiff and not open completely.
When the heart valves do not open completely, the flow of oxygen-rich blood to the brain and the body is restricted, and the heart must work harder to push blood through the body.
What are the advantages of TAVR over traditional open heart surgery?
TAVR is a less invasive option for treating aortic stenosis. A less invasive procedure allows patients to return to their daily activities and get back on their feet quicker. Especially among the elderly, the ability to resume activity and return to a quality of life is important for overall health and well-being.
Traditionally, open heart surgery is used to completely remove the diseased aortic valve and replace it with a prosthetic valve. Open heart surgery requires an incision across the breast bone, or sternum, and requires the assistance of a heart lung machine to take over the function of the heart during the procedure. The surgery is a several-hour procedure and the recovery process can be lengthy.
TAVR utilizes a minimally invasive, catheter-based technique, typically only requiring mild sedation. A small incision is made in either the leg (called the transfemoral approach), the bottom of the heart (transapical approach), or at the top of the heart (transaortic approach). A catheter is then inserted to gain access to the diseased valve. A balloon at the end of the catheter is inflated to open up the valve opening so that the diseased valve can be removed. The valve is then replaced with a stented valve (a stent).
The total TAVR procedure varies from about 1-2 hours. The approach used for the procedure will be determined by your surgical team, based on several factors, including medical history, condition of your arteries and your body structure.
What determines whether I am a candidate for a TAVR procedure?
TAVR is not right for everyone. Your heart team, which may consist of your primary care physician, a cardiologist and cardiothoracic surgeon will determine whether you are a candidate.
TAVR is for those whom are determined as high risk for traditional open heart surgery, which are typically patients who are over the age of 70 and have other medical conditions.
What are the symptoms of aortic stenosis?
Symptoms of aortic stenosis can include:
- Chest pain or pressure
- Shortness of breath
- Lightheadedness, dizziness and/or fainting
- Heart palpitation, pounding or racing
- Difficulty when exercising
- Swelling of the legs
These symptoms can often be misunderstood as just part of the normal aging process or related to other conditions. However, if you suffer from these symptoms and/or notice a change in your ability to perform routine daily activities, we recommend your consult with doctor. Aortic stenosis is a serious condition and can be life-threatening if left untreated.
How is aortic stenosis diagnosed?
Your healthcare team will determine the necessary tests for a proper diagnosis. Most common for reviewing heart valve problems is an echocardiogram. Other tests could include an exercise test, chest x-rays, CT scan, or an exploratory cardiac cath/catheterization.
How long would I have to stay in the hospital after the TAVR procedure?
The length of your hospital stay will be dependent on several factors, including your individual condition. Typically, a patient can expect to be in the hospital for 3-5 days following a TAVR procedure.
How soon could I return to my normal activities?
Every patient’s recovery process is unique, but a typical recovery time following TAVR is 1-2 weeks.
Your individual medical condition plays a big factor in the recovery process. There are also things you can do before and after surgery to aid in the process. Taking care of yourself, getting plenty of rest, stopping smoking, limiting alcohol consumption, and eating a well-balanced diet will help prepare your body before surgery.
As with any surgical procedure, you will feel weak and fatigued after surgery. So, it’s important to listen to your body and gradually increase your activity level.
Your post-surgery recovery also has a lot to do with your pre-surgery condition., and there are things you can do to help get yourself ready for your surgery. Typically, those who are physically active, stop smoking, limit alcohol consumption, and eat a well-balanced diet prior to surgery will recover with more ease.
Your surgeon will determine when you can start driving again, which would be after your follow-up appointment and after you’re no longer taking pain medications. Follow-up appointments are typically 2-6 weeks after surgery.
Brett Grizzell, MD, FACS, is a cardiothoracic surgeon with Wichita Surgical Specialists, PA. He specializes in robotic lung resection and minimally invasive lung resection for the surgical treatment of lung cancer. Dr. Grizzell, along with Dr. Sanjay G. Khicha, also of Wichita Surgical Specialists, is part of the structural heart program at Via Christi. The structural heart program was first introduced to the Wichita community in early 2012.
Brett Grizzell, MD, FACS, is a cardiothoracic surgeon with Wichita Surgical Specialists, PA. He specializes in robotic lung resection and minimally invasive lung resection for the surgical treatment of lung cancer.
Dr. Grizzell, along with Dr. Sanjay G. Khicha, also of Wichita Surgical Specialists, is part of the structural heart program at Via Christi. The structural heart program was first introduced to the Wichita community in early 2012.