Transcatheter aortic valve replacement (TAVR) is an effective treatment for people with aortic stenosis (narrowing of the aortic valve opening). Instead of open heart surgery, we can replace the valve using minimally invasive procedures.
TAVR: A minimally invasive solution for aortic stenosis treatment
Your heart has 4 valves that control blood flow. If one of these valves is damaged, like in aortic stenosis, it can make your heart work harder, leaving you tired and short of breath. Aortic stenosis happens when the aortic valve becomes stiff or narrow.
Transcatheter aortic valve replacement, or TAVR, is a minimally invasive procedure that replaces the damaged valve. Using small cuts and a thin tube (catheter), doctors can place a new valve without open-heart surgery.
TAVR is part of interventional cardiology, which uses special tools to treat heart problems with less pain, smaller scars and faster recovery. It’s especially helpful for those who can’t have traditional surgery due to other health issues. TAVR can help your heart work better and get you feeling healthier sooner.
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Conditions
The aortic valve connects the aorta to the left ventricle, which pumps blood throughout the body. In people with aortic stenosis, calcium builds up on the valve, causing it to tighten or not open properly. This can lead to symptoms like:
- Chest pain
- Fainting
- Fatigue
- Feeling lightheaded
- Shortness of breath
The best way to treat this is by replacing the damaged valve. TAVR is a lifesaving procedure that uses small incisions to deliver a new valve.
Additionally, people with aortic valve disease may benefit from TAVR to restore healthy heart function.
Testing
During your initial consultation, you'll meet with a team of experts, including a cardiac surgeon, interventional cardiologist and nurse practitioner, who will make sure you're healthy enough for the procedure.
We'll also keep your primary care doctor and cardiologist involved every step of the way.
Treatments
TAVR is a way to fix a stiff or damaged aortic valve caused by aortic stenosis. Normally, the aortic valve works like a door, letting blood flow smoothly in one direction. When it’s damaged, the heart can’t pump blood as easily.
Doctors often fix this problem with open-heart surgery, but not everyone can have such a big operation. TAVR is a less invasive option that helps your heart pump blood better and allows you to recover faster.
Who can have TAVR?
TAVR is typically suggested for people over 30 who fall into one of these categories:
- Those at very high risk for open-heart surgery.
- Those at high risk for open-heart surgery.
- Those at moderate or intermediate risk for open-heart surgery.
TAVR can restore normal blood flow to help people in these groups get their hearts and lives back on track faster and with fewer problems.
Approaches to TAVR
There are several approaches to TAVR, and the selection of the most suitable one depends on factors like your anatomy and overall health. Here are the main approaches:
- Transfemoral approach: This is the most common way to do TAVR. The doctor makes a small cut in your groin to reach the femoral artery. Using an X-ray or ultrasound for guidance, they move a thin tube called a catheter through the artery and place the new valve in your heart. About 80% of people can have this approach because it’s simple and works well.
- Transaortic approach: We make a small cut under the collarbone to reach an artery and place the valve in the aorta.
- Transapical approach: We make a small cut in the chest to place the valve directly in the aorta.
What to expect during the TAVR procedure
We perform TAVR in a hybrid operating room, combining surgical techniques and advanced imaging technology.
- Preparing for surgery: The procedure takes about 2 hours. You’ll be under general anesthesia, so you’ll sleep comfortably the entire time.
- Accessing the heart: Your doctor will make a small cut to access a blood vessel, depending on your TAVR approach. Using imaging for guidance, they’ll thread a catheter to your heart.
- Placing the prosthetic valve: The prosthetic valve is guided to your heart through the catheter, where it expands, replacing your diseased valve and restoring normal blood flow.
- Removing the catheter: Your doctor will confirm the valve is working properly before removing the catheter and closing the incision.
- Recovery: You’ll wake up in the post-anesthesia care unit and stay in the hospital for about 2 days. Once home, rest and relax. Most people feel back to normal within 2–3 weeks.
The tests all showed I would be a good candidate for the TAVR procedure...Thanks to Tufts Medical Center I was able to dance and celebrate at my grandson’s wedding.
Tufts Medical Center
Locations
Tufts Medical Center CardioVascular Center
800 Washington Street
Proger Building at Floating Bridge, 6th floor
Boston, MA 02111
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