Transcatheter Aortic Valve Replacement (TAVR)

What Is Aortic Stenosis?

Your heart’s aortic valve should open and close freely, allowing blood to flow through your heart. When your heart valve is too narrow or stiffens due to calcium buildup, the condition (aortic stenosis) restricts blood flow.

Aortic stenosis is the most common type of heart valve disease. An estimated 1.5 million people in the U.S. are currently diagnosed with this debilitating condition.

What Is TAVR?

With aortic stenosis, simply breathing can be difficult. For some people, open heart surgery to replace the aortic valve isn’t an option because of their health or scarring from previous heart surgery.

In these cases, doctors can replace the aortic valve using a lifesaving, minimally invasive procedure, without open heart surgery. The transcatheter aortic valve replacement (TAVR) procedure can correct severely diseased aortic valves in high-risk patients.

Understanding the Need for TAVR

Aurora Health Care offers the largest and most experienced TAVR program in the region. As pioneers in this minimally invasive approach, we’ve helped more than 1,000 people regain their heart valve function, their energy and the lives they love.

Wisconsin’s Largest TAVR Program

Our interventional cardiologists performed the first TAVR procedure in Wisconsin. Today, we perform more replacements than any other health system in the region.

• Unmatched experience: We have completed more than 1,000 TAVR procedures. Our program is one of the top five in the U.S. based on the number of people we treat, results, clinical trials and training.
• Effective care: Our program draws people from around the world who have been told they have no other treatment options. And people who have a TAVR go home 3 days sooner, on average, than those who have surgical heart valve replacement. Learn more about heart valve repair and replacement.
• Advanced procedures: Because of our high volume of complex heart procedures, we can provide people with access to advanced technology that no other system in Wisconsin can offer. Plus, we offer multiple active clinical trials that offer the latest treatment methods not widely available. Find out more about clinical trials and cardiovascular research.
• Team collaboration: Our cardiovascular surgeons and cardiologists work together to perform complex procedures that are less invasive. In the case of TAVR, we use only a small hole in the groin or chest to insert the catheter. Our team approach can result in better experiences and superior results after surgery. Meet our cardiovascular and thoracic team.
• Leader in the field: In 2015, we were designated a national TAVR physician training center. We also host Wisconsin’s largest physician fellowship training program. We’re not only the acknowledged experts in TAVR – we’re teaching others so that they can benefit from our expertise. Read more about our accomplishments.

What to Expect From a TAVR Procedure

TAVR is a minimally invasive procedure to replace the aortic valve and treat aortic stenosis. Doctors perform TAVR through a blood vessel in the groin or small incision in the chest, which makes opening the chest unnecessary.

TAVR requires only a small incision to insert the catheters (thin, flexible tubes) and takes less time than traditional open heart surgery. These benefits plus avoiding the need to open the breastbone result in a shorter recovery time.

Before the TAVR Procedure

Before you have a TAVR procedure, you’ll have a few medical tests, such as:

• A cardiac catheterization to check the arteries in your heart
• A CAT scan of your chest and abdomen to help our team choose the right size of replacement valve
• Pulmonary function testing to evaluate your breathing
• Lab tests to check your kidney function, electrolytes and blood counts

During the TAVR Procedure

We perform TAVR in our hybrid cardiac cath (catheterization) lab. The anesthesiologist (doctor who puts you to sleep and manages pain), cardiologist (heart specialist) and heart surgeon work together to perform the procedure.

1. You’ll be asleep under conscious sedation throughout the procedure.
2. We’ll closely monitor your blood pressure, heart rate and breathing.
3. The doctor threads a catheter through a small incision in your groin or chest.
4. We place the new valve inside the old aortic valve.
5. Once the replacement valve is in place, we expand it so that it pushes the old valve aside and takes over the function.
6. This artificial valve allows blood to flow more efficiently through the heart.

The procedure takes about one and a half hours, less time than open heart surgery.

Recovery

After we complete the heart valve replacement, you’ll go to a recovery room or the intensive care unit (ICU).

1. You’ll be in the ICU for one to two days.
2. If you’ve stayed in the ICU, you’ll move next to the cardiac step-down unit.
3. You’ll work with physical and occupational therapists and cardiac rehab staff to start moving around again.
4. Most people go home after two to four days.
5. You can expect about a one-week recovery period.

Most people receive a blood thinner, such as aspirin and/or clopidogrel (Plavix^®), after the procedure. You’ll keep taking this medication until your doctor says it’s OK to stop.