What is Transcatheter Aortic Valve Replacement?
If a cardiac surgeon determines that you are at high risk or too sick for open heart surgery, and if medicine is not helping you feel better, TAVR allows a new valve to be inserted within your diseased aortic valve while your heart is still beating.
This minimally invasive surgical procedure repairs the valve without removing the old, damaged valve. Instead, it wedges a replacement valve into the aortic valve’s place.
Somewhat similar to a stent placed in an artery, the TAVR approach delivers a fully collapsible replacement valve to the valve site through a catheter.
Once the new valve is expanded, it pushes the old valve leaflets out of the way and the tissue in the replacement valve takes over the job of regulating blood flow.
Usually valve replacement requires an open heart procedure with a “sternotomy.”, in which the chest is surgically separated (open) for the procedure. The TAVR procedure can be done through very small openings that leave all the chest bones in place.
The TAVR procedure is performed using one of two different approaches, allowing the cardiologist or surgeon to choose which one provides the best and safest way to access the valve:
- Entering through the femoral artery (large artery in the groin), called the transfemoral approach, which does not require a surgical incision in the chest
- Using a minimally invasive surgical approach with a small incision in the chest and entering through a large artery in the chest or through the tip of the left ventricle (the apex), which is known as the transapical approach.
Who is a good candidate for this type of valve surgery?
TAVR provides a unique option for patients who are at an elevated risk for surgical aortic valve replacement often due to age or presence of other conditions. TAVR also provides a treatment modality for those who are not candidates for traditional open heart surgery.
What is aortic stenosis?
Aortic stenosis is a narrowing of the aortic valve opening that does not allow normal blood flow. In elderly patients, severe aortic stenosis is sometimes caused by the build-up of calcium on the aortic valve’s leaflets. Over time the leaflets become stiff, reducing their ability to fully open and close. When the leaflets don’t fully open, the heart must work harder to push blood through the aortic valve to the body.
Who is part of the TAVR team?
The TAVR team is a highly-trained, interdisciplinary team, encompassing 15 to 20 specialists, including cardiac surgeons, interventional cardiologists, radiologists, anesthesiologists, advanced nurse practitioners, nurses and technologists. Dr. Michael Wood, Cardiothoracic Surgeon, and Dr. Jeffrey Levisman, Interventional Cardiology, heads the team.