Transcatheter Aortic Valve Replacement (TAVR)

Transcatheter aortic valve replacement (TAVR) is a nonsurgical, minimally invasive approach for patients with severe aortic stenosis, which is the narrowing of the heart’s aortic valve opening that restricts blood flow.

TAVR is an advanced heart valve replacement procedure and nonsurgical alternative for patients who are not recommended for open heart surgery. TAVR is minimally invasive, which can help reduce discomfort and recovery time. 

What is aortic stenosis?

Aortic stenosis is a heart condition caused by the narrowing of the aortic valve opening due to calcium buildup, birth defect or rheumatic fever. When the valve narrows, it does not open or close properly, which makes the heart work harder to pump blood through the body. This can cause the heart to weaken and function poorly, which can lead to heart failure and an increased risk for sudden cardiac death.

Symptoms of aortic stenosis may include:

• Chest pain or pressure
• Dizziness
• Fatigue
• Fainting
• Heart murmur
• Heart palpitations
• Shortness of breath during activity

Symptoms of aortic stenosis are often under-treated and confused with signs of aging. Patients are encouraged to see their cardiologist for treatment recommendations.

Treating aortic stenosis

Treatment for severe aortic valve stenosis is typically managed by a team of experienced cardiologists and cardiovascular surgeons who collaborate to determine the most appropriate care for each patient. Medications do not cure aortic stenosis but are sometimes prescribed to help control symptoms, maximize heart function, control blood pressure and control heart rhythm disturbance.

Surgical aortic valve replacement (SAVR) is the traditional treatment for patients with aortic stenosis. SAVR is an invasive surgical procedure and many patients are at high risk for surgery, or are altogether ineligible for surgery, therefore TAVR provides a new option for many patients.

How TAVR works

TAVR is catheter-delivered aortic heart valve replacement. There is no need for a heart-lung machine because the procedure is performed while the heart is beating. A TAVR valve is made of biological material and is supported with a metal stent.

There are four different approaches to TAVR:

1. From the femoral artery through the groin
2. Through a small incision on the chest wall
3. Through the heart's aorta
4. From the artery under the collar bone

A catheter is advanced into the pumping chamber of the heart under direct guidance using various imaging techniques. The heart valve is compressed and placed on a balloon catheter. The valve is positioned inside the diseased aortic valve. The balloon valve is then inflated to secure the valve in place.

Watch this video to see how TAVR works