Transcatheter Aortic Valve Replacement (TAVR) for Aortic Stenosis

What Is TAVR?

In TAVR, a long, thin tube (catheter) is inserted into a blood vessel through the groin and guided to the heart. A new heart valve is placed inside the diseased aortic valve through the catheter. Once in place, the new valve pushes the old valve flaps out of the way so that the new one takes over the job of regulating blood flow.

TAVR is much less invasive than open heart surgery and allows implantation of a new heart valve without opening the chest. The replacement valve is made from animal tissue, most often heart tissue from a cow or pig.

Benefits of TAVR?

TAVR has a variety of benefits for patients, including:

• Light sedation and local anesthesia.
• Minimal blood loss compared with open heart surgery.
• Lower risk of heart and lung complications.
• Shorter time in the hospital.
• Faster recovery.
• Improvement in patient quality of life.

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Who Should Consider TAVR?

Nearly all patients with severe aortic stenosis are eligible for TAVR, regardless of their surgical risk. You will be evaluated by our team of interventional cardiologists, cardiac surgeons and specially trained nurses to determine your eligibility for the procedure.

Why Choose University Hospitals for TAVR?

Offering TAVR since 2011, University Hospitals Harrington Heart & Vascular Institute is recognized internationally for developing and perfecting TAVR techniques, and for the number of patients we’ve treated. In 2014, we pioneered performing TAVR under conscious sedation in the U.S., providing a minimally invasive option with easier recovery. We’ve trained more than 800 healthcare providers across the U.S. in this technique.

Over the years, we’ve also trained thousands of doctors and other medical personnel throughout the world to achieve the best possible patient outcomes when performing TAVR. These training efforts have included numerous live broadcasts that allow trainees to ask us questions as they watch and learn the TAVR procedure in real time.

Diagnostic Testing Before TAVR

• An echocardiogram (ultrasound) of the heart examines the heart valves and how they function. Your cardiologist may have already done this test.
• A heart catheterization evaluates blood flow to the heart. This test will require recent blood work and you may need to stop certain medications to prepare.
• A computed tomography (CT) scan examines the heart valve, and the condition and size of the blood vessels used to insert the valve.
• A cardiac magnetic resonance imaging (MRI) may be scheduled for further assessment of your heart and heart valves.
• Periodic bloodwork and additional tests may be recommended.

What to Expect During the TAVR Procedure

1. On the day of your procedure at the hospital, you’ll receive medication through an IV to help you relax. You may also receive medication to prevent blood clots and infection.
2. The TAVR procedure team typically consists of an interventional cardiologist, a cardiac surgeon, an echocardiographic imaging specialist, skilled nurses and a cardiac anesthesiologist. The interventional cardiologist and cardiac surgeon work closely together to perform overlapping tasks.
3. Once you’re in the operating room, your doctor will make two very small incisions, usually in the legs near the groin. A catheter is then inserted to reach the femoral artery, the largest blood vessel in the leg.
4. Assisted by imaging, your doctor guides the catheter to the aortic valve.
5. A new valve is implanted through the catheter and the old valve is pushed aside.
6. Your doctor confirms the new valve is working properly and closes the incision.

Recovery After TAVR

Immediately following your procedure, you will be asked to lie flat for at least four hours to help the catheter access sites heal properly. You will also have lab work, an electrocardiogram (EKG) and a chest x-ray. If you did not walk the halls after your procedure on the same day/night, you will be expected to walk the next day before you can leave. Often after the TAVR, you blood pressure will be lower than normal, so adjustments to medications may be needed.

About 90 percent of TAVR patients stay in the hospital for 24 hours or less. Once home, you can resume light activities, but you will need assistance for a week. You shouldn’t drive for a week, or push, pull or lift anything heavier than 10 pounds. You can walk and take stairs slowly, but you should avoid treadmills and strenuous exercise for at least one week.

Patients can shower when they get home, but don’t take a bath or swim until your access sites have healed. All bandages should be removed three days after the procedure and left open to air. Do not have any dental procedures for three months. Patients are also expected to check their blood pressure at home at least 1 to 2 hours after taking any cardiac medications.

Some patients start feeling improvement in symptoms as early as one week after the procedure. You may feel fatigue when you first return home. This symptom will improve, especially once you resume walking or regular exercise. Most patients feel significantly better after one month. Physical therapy or cardiac rehabilitation can help speed recovery.

Follow-up appointments will be scheduled for one week, 30 days and one year after your TAVR procedure. Virtual appointments are available as an option. After discharge, we may recommend cardiac rehabilitation or physical therapy appointments. You should also schedule follow-up appointments with your cardiologist and/or primary care provider.