Transcatheter Aortic Valve Replacement (TAVR)

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Transcatheter Aortic Valve Replacement (TAVR)

Overview

What is the TAVR heart procedure?

TAVR is a lifesaving, minimally invasive surgical procedure that’s used to treat aortic stenosis. Aortic stenosis happens when your heart valve is too narrow or stiff due to calcium buildup, and blood can’t flow freely through the valve. This condition can make it hard to breathe and can even be life-threatening.

During a transcatheter aortic valve replacement (TAVR) — sometimes called an implantation (TAVI) — your surgeon inserts a replacement aortic valve to the site of the damaged aortic valve using a catheter. After the new aortic valve is put in place, it starts to take over the work of the damaged valve and regulate blood flow on its own.

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.

World-Class Care

Wisconsin’s Largest TAVR Procedure 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, making us one of the highest volume TAVR centers in the state. 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 traditional 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 top TAVR 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. That means we don’t just have hospitals that do TAVR — we also host Wisconsin’s largest physician fellowship training program. In addition to having some of the best aortic valve replacement surgeons in the world, we’re teaching others so that they can benefit from our expertise. Read more about our accomplishments.

TAVR Vs Open Heart

TAVR Vs Open Heart Surgery

In many cases, aortic valve replacement requires open heart surgery. During this surgery, known as a sternotomy, surgeons open a patient’s chest so they can access the aortic valve.

But 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.

If traditional valve replacement surgery is considered too high-risk, TAVR is FDA-approved to address and correct diseased and damaged aortic valves. Because it is minimally invasive, the risk of major complications is lowered and hospital stays tend to be shorter.

TAVR Steps

TAVR, Step-by-Step: Before, During and After Your Procedure

TAVR is a minimally invasive procedure to replace the aortic valve and treat aortic stenosis. Doctors perform TAVR by inserting a replacement valve through a blood vessel in the groin or small incision in the chest. This 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.

After the TAVR Procedure

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.

TAVR Risks

TAVR Risks and Complications

Like all procedures, there are certain risks and complications involved when undergoing a TAVR. These could range from issues with the replacement valve to heart rhythm abnormalities or infection, and in rare cases, death.

If you’re wondering if a TAVR procedure is safe, know that’s it’s often the best choice for patients with intermediate or advanced aortic stenosis. For these people, TAVR may actually improve overall health and lower the risk of death.

TAVR Procedure Survival Rates

The main benefits of a TAVR procedure include shorter hospital stays and fewer major complications than open heart surgery. According to the American College of Cardiology, survival rates between TAVR and open heart surgery are similar in the two years following the procedure for high-risk patients.

Muriel’s Story

Muriel first noticed something was wrong when she was too tired for the hobbies she loved. See how TAVR gave this 89-year-old grandmother her life back.
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