Transcatheter Aortic Valve Replacement (TAVR)
Treating Cardiovascular Diseases in Wisconsin and Northern Illinois
Transcatheter Aortic Valve Replacement (TAVR) is a treatment option for patients who are too sick or high risk for surgical aortic valve replacement. The procedure is used for patients who have aortic stenosis with severe symptoms.
Severe aortic stenosis is a disease affecting the aortic valve in the heart. It is a narrowing of the heart valve, which prevents blood from flowing through the valve normally.
In many older patients, this valve problem is related to the build up of calcium on the leaflets of the aortic valve, causing the leaflets which normally move freely to stiffen, making them difficult to open and close correctly.
This problem will ultimately cause your valve to get weaker and can cause problems like fatigue, dizziness, chest pain or pressure, heart murmur, shortness of breath during activity, heart palpitations and fainting. Treatment for this problem is usually recommended when the disease is severe. Without effective treatment, as many as 50 percent of patients with severe aortic stenosis die within two years.
The standard treatment is surgical aortic valve replacement. For patients who cannot have an open heart operation because they are high risk or not operable, physicians may recommend a Transcatheter Aortic Valve Replacement (TAVR).
TAVR is a less invasive way to replace the aortic valve that does not involve a large incision in your chest. It can be placed through a small incision in your groin with placement of a catheter which helps to place the new valve inside your old valve. The valve is then deployed and opens inside your old valve. This procedure usually takes less time than open heart surgery.
There are also other approaches used to place the valve if there are blockages in the leg arteries. This may involve a small chest incision and the valve is replaced as described above.
There are many criteria that must be met in order to figure out what treatment option is best for each patient. This valve treatment can be offered to some patients as part of a research study and some patients can get the FDA approved valve.
The TAVR procedure is done in the cardiac catheterization lab where both a cardiothoracic surgeon and cardiologist work together to provide this treatment. After the procedure is completed, the patient will be transferred to the ICU for monitoring. Many patients require a temporary pacemaker for the short term due to a slowing of their heart rhythm after the procedure.
After the heart rhythm, blood pressure and labs are stable, the patient will transfer to the step down unit for further recovery. Physical therapy, occupational therapy and cardiac rehabilitation will follow closely and help to increase mobility.
The hospital stay is 3-7 days and will involve close monitoring of labs including blood counts and kidney function. There will also be close monitoring of swelling and extra body water that often worsens after surgery.
Why Choose Aurora for a TAVR Procedure?
Aurora Health Care is a leader in cardiac care and we offer a team of experts who can help to figure out the best option for treatment of aortic stenosis. Aurora utilizes a team approach to the entire process of evaluation and treatment for TAVR.
Each patient is reviewed by a team of doctors, nurses, research personnel and ancillary staff and a group decision is made on the best treatment of each patient. This team is highly experienced in the care of patients with aortic stenosis. At Aurora Health Care we have evaluated hundreds of patients in our multidisciplinary valve program and have expertise in advising patients on the best treatment options available.
Aurora Health Care is on the cutting edge of research opportunities for aortic stenosis and offers many options for treatment through the research studies. We have extensive experience taking care of complex patients with aortic stenosis and other medical problems.
We are proud to offer not only surgical aortic valve replacement but also many minimally invasive options. We have a dedicated research team with a great deal of experience helping patients through the process toward TAVR.
How to Prepare for a TAVR Procedure
Prior to your TAVR procedure there are some tests that will need to be completed to help your doctors decide which approach is right for you. You will need to under go cardiac catheterization, a test to check the arteries in your heart. You will likely also need a CAT scan of your chest and abdomen help the team to make sure that the TAVR is the appropriate size. You will also have pulmonary function testing done to check how you breathe. Finally there will be lab testing done to check your kidney function, electrolytes and blood counts prior to your procedure.
The nurses will review with you which medications to take prior to surgery. You should not have anything to eat or drink after midnight the night before your procedure. Patients are in the hospital for 3-7 days after the procedure.
What to Expect During a TAVR Procedure
The procedure is done in the cardiac catheterization lab. The anesthesiologist, cardiologist and cardiac surgeon work together to perform the procedure. You will be completely asleep with general anesthesia throughout the procedure.
The valve is placed by using a delivery system on a tube to place a balloon-expandable heart valve. Many times this valve is placed through an artery in the leg, however in patients with small, winding or blocked arteries, the valve can also be put in through a small opening in the chest. The procedure takes a few hours and your blood pressure, heart rate and breathing are monitored closely. You will then be taken to the ICU for monitoring.
Recovery after the TAVR Procedure
After the procedure you will be sleepy and wake up in the ICU. You will have an IV line in your neck for giving medications and this may also have a temporary pacing line while your heart rate is monitored. You will have a catheter in your bladder as well. Most of the lines and tubes will be removed on the day after your procedure.
You will be in ICU 1-2 days and then will move to the cardiac step down unit where you will work on increasing your activity and getting stronger. The physical, occupational therapy and cardiac rehab departments will work with you to increase your activity.
You will have pain medication ordered to help relieve any pain after the procedure. We will monitor your heart rate and blood pressure throughout your time in the hospital.
Most patients are prescribed a blood thinner (aspirin and Plavix) after the procedure which you will remain on until your doctor indicates you should stop.
Schedule an Appointment
To schedule an appointment or to speak to with an experienced professional about the TAVR procedure, please call toll free 888-973-2663.