If your patient has been diagnosed with severely narrowed aortic valves or aortic stenosis, a cardiologist may likely discuss a minimally invasive procedure called TAVR to replace the valves. The TAVR (transcatheter aortic valve replacement) procedure provides a treatment option for those patients considered a medium or high risk for open-heart surgery.
Zaher Fanari, MD
When a patient has symptoms such as shortness of breath, dizziness, passing out or chest pain, you can explain to them this happens because the aortic valves are not able to open all the way, causing the heart to work very hard while less blood flows out of the heart to the rest of the body. Tests, ranging from stress tests to an echocardiogram, may be done to diagnose the severity of the condition.
With the TAVR procedure, the aortic valve is repaired through the use of a catheter. Generally, the catheter is inserted through the femoral artery in the groin, or it can enter through a small chest incision. The tube will then travel through the artery to the patient’s heart, and a balloon will open to put the new valve in place without the need to remove the damaged valve. After the replacement valve is put into place, the tube is removed.
TAVR is associated with faster recovery and symptom improvement than open-heart surgery. Although it depends on the patient, valves can last for six to eight years and maybe even longer. The FDA approved TAVR for high-risk and inoperable patients with aortic stenosis in November 2011.
Right now, most TAVR patients are older adults. The average age for patients enrolled in most TAVR studies was 80 to 85 years old. Cardiologists have been able to complete successful TAVR procedures on patients in their 90s.
The procedure itself usually takes one hour. On average, patients stay in the hospital two to three days after undergoing the TAVR procedure. Some patients with other diseases who need rehabilitation therapy before going home are also usually ready to leave the hospital in two to three days but may end up staying longer until a rehab spot is available.
Risks of TAVR are similar to those of surgery including death, stroke, bleeding and injuries to blood vessels, but the rate of complications is still much less than the risk of death associated with not having TAVR.
Zaher Fanari, MD, of Heartland Cardiology, is the Medical Director of the Structural Heart Program at Wesley Medical Center. For questions about the TAVR procedure or to refer patients, please call 316-686-5300.