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TAVR, or transcatheter aortic valve replacement, is a minimally invasive procedure used to replace the aortic valve in patients with severe aortic stenosis.
A cardiac surgeon and structural interventionalist use a catheter inserted into a small incision, rather than open-heart surgery, to replace the diseased valve with a new valve.
Who Would Benefit From TAVR?
If left untreated, aortic stenosis (or, aortic valve stenosis) can be life-threatening. It can decrease your quality of life, causing chest pain, shortness of breath, fatigue, fainting (syncope), arrhythmias and leg swelling.
TAVR at Valley is recommended for patients who:
- Experience severe symptoms of aortic stenosis
- Are considered medium or high-risk patients; low-risk patients may be eligible through a clinical trial
- Are not candidates for conventional open-heart surgery due to additional medical conditions
Our team of valve specialists thoroughly evaluates patients to determine whether they are a good fit for the TAVR procedure. If you are eligible for TAVR, the team will tailor a treatment plan based on your individual needs.
How Safe Is TAVR?
Traditional open-heart surgery requires general anesthesia and an opening of the chest plate. In contrast, most TAVR patients at Valley have an approach that uses only a small incision in the groin area. (See “transfemoral approach” below.)
During the procedure, a patient’s heart continues to beat, eliminating the need for a heart-lung bypass machine.
This minimally invasive approach means patients typically:
- Receive conscious sedation rather than general anesthesia
- Experience shorter intensive care unit and overall hospital stays
- Recover more quickly
- Are able to get up and walk around a few hours after the procedure
- Are discharged home in two to three days
Although minimally invasive, TAVR is still a major heart procedure. That’s why our valve team thoroughly evaluates — and discusses with you — the risks and benefits of the procedure.
Why Choose Valley for TAVR?
- Clinical excellence: The Society for Thoracic Surgeons awarded Valley’s heart program its highest recognition (three stars) for aortic valve replacement. This distinction is given to only 5.9 percent of cardiac programs nationwide.
- Positive patient outcomes: A key indicator of success for TAVR is whether there are leaks around the replaced valve after the procedure. These leaks are referred to as “paravalvular leaks.” At Valley, 100 percent of our TAVR patients had no or only mild paravalvular leakage on their follow-up echocardiogram 30 days after the procedure.
- Transfemoral approach: There are currently four common TAVR approaches for replacing the valve. With the “transfemoral approach,” valve specialists use the femoral artery (a large artery in the groin) to access the heart. This approach does not require a chest incision. In 2016, 92 percent of Valley’s TAVR procedures used the transfemoral approach.
- High volume: Valley performed 147 TAVR procedures through 2016. This volume of cases allows Valley valve specialists to better determine which high-risk patients would benefit from a minimally invasive approach like TAVR, and which should undergo a traditional aortic valve replacement surgery.
- Convenient pre-procedure testing: Potential TAVR patients need to have a variety of tests to assess their eligibility for the procedure. Valley coordinates a “screening day” for these patients so they can have everything done in one day for their convenience.
- Patient navigator service: At this screening day, Valley offers a patient navigator service for patients who do not have someone to accompany them to the tests. The patient navigator escorts patients to the different office locations for the tests. The navigator carries a phone so family members can check in to see how their loved one is doing.