TAVR: A Less Invasive Option for Aortic Valve Repair
Dr. Prashant Atri discusses TAVR at Pulse
Transcatheter Aortic Valve Replacement (TAVR)
Aortic stenosis is a serious valve disease problem that occurs in about 2 percent of people over the age of 65. It occurs when your aortic valve is obstructed, causing the heart to work harder to pump blood throughout your body. Over time, the obstruction limits how much blood the heart can pump — in turn, weakening the heart.
MultiCare’s Pulse Heart Institute has been treating patients with aortic stenosis for many years with traditional open-heart surgery and, since 2014, with the less invasive transcatheter aortic valve replacement (TAVR) procedure. TAVR, a minimally invasive procedure to replace a diseased aortic valve, alleviates the symptoms of aortic stenosis and is an option for patients who are too sick, or have too many other high-risk issues, to undergo open-heart surgery. Pulse was the first healthcare system in the South Sound to offer this procedure.
Symptoms of aortic stenosis
Aortic stenosis can range from mild to severe, and symptoms may vary depending on severity. Some signs and symptoms of aortic stenosis may include:
- Shortness of breath, notably while doing activities
- Feeling dizzy or light-headed
- Heart murmur or abnormal heart sounds
- Heart palpitations
- Chest pain or tightness
What is the TAVR procedure?
TAVR is a minimally invasive procedure designed to replace a diseased aortic valve. It has a high success rate. Because the procedure is less invasive, recovery time is less than that of other procedures. Most people are up and walking within hours after their TAVR, and many patients return home with their caregivers one day after the procedure.
TAVR works by inserting a new valve inside the diseased aortic valve, without requiring the chest to be opened. A balloon-expandable aortic heart valve is inserted into the body using a catheter. In most cases, an incision is made in the upper leg and the catheter is inserted through a large artery in the thigh. Once the catheter is inserted into the artery, the catheter is guided up to your heart and the diseased valve is replaced. This less-invasive procedure simplifies valve replacement for patients.
Depending on the situation, other possible locations for inserting the catheter include:
- Through a large artery in the chest via a small incision in the chest
- Through the tip of the left ventricle via a small incision between the ribs
As with any heart procedure, TAVR does come with some risks. Complications include bleeding, heart attack, kidney injury, stroke, blood clots, heart rhythm abnormalities, infections that affect the heart, need for a permanent pacemaker and death. Consult with your provider to learn more about the risks involved.
Who is eligible for TAVR?
Patients who have severe aortic stenosis are evaluated for TAVR based on factors such as:
- Serious comorbid, or related conditions
- Any other condition that would make TAVR a better option than open-heart surgery
What to Expect
Patients with aortic stenosis are referred to a cardiologist, a doctor who specializes in treating the heart. Symptoms will be evaluated to confirm the severity of the aortic stenosis and reviewed with Pulse’s multidisciplinary Valve Team to determine the best care pathway. If TAVR is determined to be the best option, a TAVR workup is completed. The workup involves several different exams and tests that help the Valve Team confirm the severity of the aortic stenosis and determine the best size valve and access to use – specific to each individual patient’s heart.
Living with aortic stenosis comes with lifestyle changes. The Pulse Heart Institute is committed to offering the latest medical procedures for patients living with this disease and helping people with aortic stenosis regain their independence.
The first step in addressing your heart concerns is to schedule an appointment with one of our cardiologists. They have the expertise you need to evaluate, diagnose and recommend the right treatment for you.
To schedule an appointment, or refer a patient, please call our referral line at 253-572-7320 (Puget Sound Region) or 509-755-5500 (Inland Northwest Region).