Who should have TAVR?
For patients who have been deemed high or greater risk for traditional open-heart surgery, a procedure called transcatheter aortic valve replacement (TAVR) may be a treatment option. TAVR allows the aortic valve to be replaced, and like open-heart surgery, TAVR produces results in improving patients’ quality of life and lifespan. Patients with a history of stroke, prior chest radiation, prior open-heart surgery, COPD, frailty, renal insufficiency, advanced age, and other conditions may be appropriate for TAVR.
What happens if I do not receive aortic valve replacement?
Patients may live with aortic stenosis for many years during a latent asymptomatic period that precedes the point that symptoms of the disease develop. However, after patients begin experiencing symptoms, prompt treatment becomes necessary.
Once symptoms appear, untreated patients have a poor prognosis. Patients with severe aortic stenosis have an increased risk of death from approximately 25% at one year and 50% at two years following onset of symptoms.
What are the advantages of TAVR over open-heart surgery?
Some of the advantages of TAVR include shorter hospital stays and quicker recovery times. In addition, many TAVR procedures are done under sedation instead of general anesthesia.
What are the risks of TAVR?
As with any procedure, there are a few risks. Some of the risks for TAVR include bleeding at the catheter insertion site, vascular damage, infection, abnormal heart rhythms, and stroke. These and other risks will be discussed during the screening process.
What is the usual work-up for TAVR?
The TAVR screening process utilizes a patient-focused approach. Our interdisciplinary team represents a strong partnership between cardiac surgery, interventional cardiology, cardiac nurses, cardiac imaging specialists, and our valve coordinator to offer our patients the highest level of expertise and care. Not only will the patient meet with an interventional cardiologist, but they will see two separate surgeons to help determine the right approach. CHI Memorial’s interdisciplinary heart team meets weekly to review cases and plan the best approach for each patient.
The screening process for TAVR is extensive, and includes a complete medical history, an EKG, and an echocardiogram. If the patient is deemed to be a good candidate for surgery or TAVR, cardiac catheterization is performed to exclude significant coronary artery disease. A CT of the chest is performed to evaluate the anatomy of the heart.
Other tests may include a CT of the abdomen and pelvis, a chest x-ray, ultrasound of the arteries in the neck, and pulmonary function studies. Additional studies may be ordered by the physicians based on an individual’s specific conditions.
What is the typical hospital stay?
Typically a patient will spend about one to five days in the hospital, depending on the approach used in the TAVR procedure.
Are there any major restrictions after the procedure?
Each patient receives detailed instructions after the procedure to ensure a full recovery. They are encouraged to stay active during the recovery process. While on pain medication, patients are discouraged from driving or operating heavy machinery.