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Transcatheter Aortic Valve Replacement (TAVR)

Definition

A transcatheter aortic valve replacement (TAVR) replaces a damaged heart valve with a new valve. These valves help manage the flow of blood through the heart.

Reasons for Procedure

This surgery is done to treat aortic valve stenosis. It will repair the valve to help blood flow out of the heart. TAVR can ease the symptoms and improve overall health.

Open heart surgery has been the only way to replace a valve. TAVR may be a new option for some. It should cause less pain and have shorter recovery time than open surgery.

Possible Complications

Problems are rare, but all procedures have some risk. Your doctor will go over problems, like:

  • Adverse reaction to anesthesia
  • Infection
  • Blood clots
  • Bleeding
  • Kidney damage or disease
  • The valve does not work as it should
  • Heart rhythm problems
  • Heart attack or stroke

Things that may raise the risk of problems are:

  • Smoking
  • Long term health issues such as diabetes

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and if they need to be stopped before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Whether you need a ride to and from surgery
  • Specialists you may need to see
  • Tests that will be need to be done before surgery

Anesthesia

 anesthesia may be used. It will block pain and keep you asleep.

Description of the Procedure

IV medicines will be given. They will help lower the chance of infection and blood clots. A pacemaker may be placed. A small wire will be threaded through blood vessels and into the heart. It will make sure the heart is beating at a steady rhythm.

A small incision will be made in the leg or chest. A hollow tube will be inserted in the incision. The new valve sits inside the tube. A machine will take images of blood vessels to show where the tube is in the body. The tube will be passed through blood vessels until it reaches the damaged valve. The new valve will push the damaged valve flaps out of the way and sit over the old valve. The damaged valve does not need to be taken out.

Images will be taken to make sure the new valve is working as it should. Then the tube will be removed. The incision will be closed and covered with bandages. The pacemaker may be removed or may be left in place.

How Long Will It Take?

90 minutes

Will It Hurt?

Anesthesia will prevent pain during surgery. The incision site will be sore. Pain medicine will ease discomfort.

Average Hospital Stay

Most people stay 2 to 5 days. Some may need to stay longer if there are problems.

Post-procedure Care

The care team will watch vital signs. Medicines may be given to prevent blood clots. Walking will help blood flow and reduce risk of clots.

Staff will take steps to lower your chance of infection such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping incisions covered

Take these steps to lower your chances of infection:

  • Washing your hands often and reminding others to do so
  • Reminding staff to wear gloves or masks
  • Not letting others touch your incisions

It will take many weeks to fully heal. Problems caused by aortic stenosis should be improved. Heavy lifting and straining will be limited for up to a week.

Problems To Look Out For

Call your doctor if you are not getting better or you have:

  • Signs of infection, such as fever or chills
  • Nausea and vomiting
  • Heavy bleeding
  • Redness, swelling, or any discharge from the incision
  • Pain that does not go away with the medicines given

Call emergency medical services right away for:

Signs of a stroke:

  • Face drooping
  • Arm weakness
  • Speech problems

Signs of a heart attack:

  • Squeezing or tightness in the chest, shoulders, or back
  • Pain in the arms, back, neck, or jaw
  • Breathing problems

If you think you have an emergency, call for medical help right away.

References

  • Aortic stenosis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/aortic-stenosis.
  • Grimard, B.H., Safford, R.E., et al. Aortic Stenosis: Diagnosis and Treatment. Am Fam Physician, 2016 ; 93 (5): 371-378.
  • Transcatheter aortic valve replacement (TAVR). Stanford Health Care website. Available at: https://www.sanfordhealth.org/-/media/org/files/patient-education/019051-00247-booklet-patient-education-tavr-level-2-8%5F5x11.pdf.
  • Transcatheter aortic valve implantation (TAVI)/replacement (TAVR). EBSCO DynaMed website. Available at: https://www.dynamed.com/procedure/transcatheter-aortic-valve-implantation-tavi-replacement-tavr-29.
  • What is TAVR? American Heart Association website. Available at: https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/understanding-your-heart-valve-treatment-options/what-is-tavr.
  • What is TAVR? Stanford Health Care website. Available at: https://stanfordhealthcare.org/medical-treatments/t/transcatheter-aortic-valve-replacement-tavr.html.
 
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