TRANSCATHETER AORTIC VALVE REPLACEMENT(TAVR)

Transcatheter Aortic Valve Replacement (TAVR), also known as Transcatheter Aortic Valve Implantation (TAVI), is an innovative approach to replacing the aortic valve without open-heart surgery.This is a revolutionary new treatment option for patients with severe aortic stenosis who are not well enough to undergo traditional open heart surgery. The TAVR procedure gives hope for extending the lives of these patients with improved quality of life.This heart valve replacement is minimally invasive which means a majority of patients will experience faster recovery times than traditional open-heart valve replacement.

Aortic Stenosis

Patients who suffer from aortic stenosis- a progressive disease that affects the aortic valve of the heart- often experience symptoms that can restrict normal day-to-day activities, such as walking short distances or climbing stairs. Severe aortic stenosis is a serious problem. Patients who do not receive an aortic valve replacement (AVR) have no effective, long-term treatment option to prevent or delay their disease progression. Without it, severe aortic stenosis is life threatening – studies indicate that 50 percent of patients will not survive more than an average of two years after the onset of symptoms.

TAVR Criteria

Until now, the only treatment for severe aortic stenosis has been open aortic valve replacement, but if a cardiac surgeon determines that you are not a candidate for open-heart surgery and if medicine is not helping you feel better, the TAVR procedure may be an alternative. TAVR is approved for patients who have shortness of breath or chest pain from a severely narrowed aortic valve and who are to sick for an open aortic valve operation.Most people who have this procedure are in their 70s or 80s and often have other medical conditions that make them a better candidate for this type of surgery. 

TAVR Procedure

During the valve replacement procedure, a cardiologist inserts a tube (catheter) through an artery in the groin (transfemoral approach) or a small incision between the ribs (transapical approach).The transcatheter heart valve is compressed into the end of the catheter.The valve is made of bovine or cow tissue and polyester supported with a stainless-steel mesh frame. Once released from the catheter, the heart valve is expanded with a balloon and immediately becomes functional.The valve is designed to replace a patient's diseased native aortic valve without traditional open-heart surgery and while the heart continues to beat – eliminating the need for cardiopulmonary bypass. 

Potential Benefits

• Fragile patients can tolerate this procedure
• Less time spent in surgery
• Less pain and quicker recovery time
• Lower risk of complications

Risks

TAVR is a significant procedure typically requiring general anesthesia. While less invasive than open heart surgical aortic valve replacement, TAVR still has the potential for similar adverse effects, including risk of death, stroke, damage to the artery used for replacement of the valve, major bleeding, and other life-threatening and serious events. The components of the TAVR valve are made from similar material as those in a conventional aortic valve replacement.