Transcatheter Aortic Valve Replacement (TAVR)
Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure for high-risk patients who have aortic stenosis and are not candidates for traditional aortic valve surgery. TAVR is catheter delivered aortic heart valve replacement.
The aorta is the main artery that carries blood out of the heart through the aortic valve. When a person has aortic stenosis, his or her aortic valve does not open fully, decreasing blood flow from the heart to the body. Severe forms of aortic stenosis can prevent sufficient blood from reaching the brain and other organs.
Aortic stenosis usually develops later in life and is caused by calcium deposits that narrow the valve. People who have aortic stenosis may have no symptoms until late in the course of the disease. The diagnosis is usually made when a heart murmur is detected and the proper tests are performed.
Symptoms of aortic stenosis include:
- Chest pain
- Breathlessness during activity
- Fainting, weakness, or dizziness with activity
- Sensation of feeling the heart beat (palpitations)
TAVR is catheter delivered and is performed while the heart is beating. This approach allows the procedure to be done without the use of a heart-lung machine. A TAVR valve is made of biological material and is supported with a metal stent.
There are four different approaches to TAVR:
- from the femoral artery through the groin
- through a small incision on the chest wall
- through the aorta
- from the subclavian 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.
This minimally invasive approach allows for a quicker recovery time for patients.
TAVR is performed in high-risk and inoperable patients with aortic stenosis. Candidates must be carefully evaluated by a cardiologist and a cardiothoracic surgeon to determine if they are eligible for treatment.