What is TAVR?
Transcatheter Aortic Valve Replacement (TAVR), a minimally invasive procedure, is a treatment option for patients with severe aortic stenosis. TAVR is performed as a team by both cardiologists and heart surgeons. Through a small incision in the leg artery, a self-expanding replacement valve is implanted. Your diseased aortic valve is not removed but is used as an anchor for the new and better functioning valve. In some instances, the leg artery cannot be utilized; however, there are alternate access options available.
TAVR patients are initially evaluated by both heart surgeons and cardiologist at the Phoebe Structural Heart to determine if TAVR is the best treatment option for your diseased valve.
For TAVR to be recommended as an appropriate treatment pathway, the evaluation must confirm the following:
- The patient has severe aortic stenosis and is causing life-threatening symptoms
- The patient’s aortic valve and blood vessels are of appropriate size to accommodate a successful TAVR procedure
- The technical aspects of the TAVR can be performed
Understanding Aortic Valve Stenosis
A healthy aortic heart valve allows oxygen-rich blood from the lungs to flow from the left ventricle of the heart to the aorta, where it then flows to the brain and the rest of the body. Severe aortic stenosis causes narrowing or obstruction of the aortic valve and is most often due to accumulations of calcium deposits on the valve’s leaflets (flaps of tissue that open and close to regulate the flow of blood in one direction through the valve often referred to as degenerative calcific aortic stenosis). The resulting stenosis impairs the valve’s ability to open and close properly. When the leaflets don’t fully open, the heart must work harder to push blood through the calcified aortic valve. Eventually, the heart’s muscles weaken, increasing the patient’s risk of cardiac stress and heart failure.
What causes aortic valve stenosis?
Problems that can cause aortic valve stenosis include:
- Calcium buildup on the aortic valve. As you age, calcium can build up on the valve, making it hard and thick. This buildup happens over time, so symptoms usually don't appear until after age 65.
- A heart defect you were born with (congenital).
- Rheumatic feverorendocarditis. These infections can damage the valve.
What are the symptoms?
Aortic valve stenosis is a slow process. For many years, even decades, you will not feel any symptoms. But at some point, the valve will likely become so narrow (often one-fourth of its normal size) that you start having problems. Symptoms are often brought on by exercise, when the heart has to work harder.
As aortic valve stenosis gets worse, you may have symptoms such as:
- Chest painor tightness.
- Feeling dizzy or faint
- Feeling tired and being short of breath – even at rest
- A feeling that your heart is pounding, racing, or beating unevenly (palpitations).
- Difficulty exercising