The New TAVR Alternative to Open Heart Valve SurgeryheadingContent

Posted on November 09, 2017

image of chest and heart glowing red

A new treatment option for people with aortic stenosis could be an alternative to traditional types of open heart surgeries. Some of the patient population diagnosed with severe symptomatic aortic stenosis may be candidates for Transcather Aortic Valve Replacement (TAVR). Until recently, this type of heart procedure, known as TAVR or TAVI, was used to repair heart valves as an open surgery. Today, TAVR is a minimally invasive cardiac treatment where a cardiology team, led by an interventional cardiologist and cardiac surgeon, repairs narrowed heart valves causing aortic stenosis by opting to insert a new replacement valve inside of the existing aortic valve instead of removing the diseased valve. Due to the minimally invasive approach, there is no need for sternotomy, or a heart and lung bypass machine.

How is the TAVR procedure performed?

To perform a TAVR procedure, your cardiology team has many approaches available in their repertoire. The team can insert the new valve from a transfemoral approach, through a small percutaneous puncture in the groin, a transapicial approach via an incision in the chest, between the ribs, or a transaortic approach, by making an Coronary catheterizationincision in the upper chest. Once the catheter is across the diseased valve, the new bovine tissue valve, which is sewn to the inside of a metal stent, is deployed by inflating the balloon on which the stent/valve is mounted. The balloon is then deflated and removed, with the stent/valve remaining in place as fully functional aortic valve prosthesis.

What is the recovery time for TAVR?

While the procedure itself only takes about 45 minutes to an hour, pre-procedure and recovery time total is approximately three hours. In most cases, patients walk out of hospital within 48 hours after their TAVR procedure, while surgical aortic valve replacement (SAVR) usually entails a four to six day post-operative hospital stay. Symptom relief in TAVR patients is almost immediate. The TAVR procedure results in a shorter hospital stay, quicker recovery time, decreased morbidity and a decreased risk of suffering a stroke.

Who is a candidate for TAVR?

When a patient is considered high risk for surgery due to advanced age, multiple other illnesses or previous open heart surgery, TAVR is often a good option and has become the standard treatment for this patient population. The technology has advanced so quickly and the results have been so favorable that intermediate or average risk patients are also candidates for TAVR. Recent evidence suggests that TAVR results in these patients is at least equivalent to SAVR and may, in fact, be superior in certain settings. TAVR has grown tremendously in the last few years as a less invasive form of aortic valve replacement. With a cardiology team approach that brings several specialties together, TAVR has paved the way for improving the treatment of patients with complex aortic valve disease. With additional ongoing trials evaluating the effectiveness of TAVR for patients at low risk for surgery, this procedure is poised to become the standard of care for aortic valve replacement in the near future.