Minimally Invasive Option for Valve Replacement
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. More than 200 TAVR procedures have been performed at GW Hospital.
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. Symptoms can include chest pain, breathlessness, fainting or weakness during activity and sensation of feeling the heart beat (palpitations). However, 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.
TAVR is catheter-delivered aortic heart valve replacement. Because TAVR is performed while the heart is beating, there is no need for 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.
Candidates must be carefully evaluated by a cardiologist and a cardiothoracic surgeon to determine if they are eligible for treatment.