The cardiology program at Providence continues to be at the forefront of providing the best possible care to patients with advanced heart disease.
For patients with severe aortic stenosis, there may be an alternative option to open-heart surgery. Transcatheter aortic valve replacement, known as TAVR, is a minimally invasive option available to some patients.
TAVR works by inserting a replacement valve into the existing aortic valve via a small incision in the groin or chest. Your doctor does not open your chest to perform this procedure. Once the new valve is placed, it immediately takes over valve function, regulating blood flow out of your heart.
TAVR is approved by the FDA for intermediate risk, high risk or inoperable surgical patients at this time.
Learn more about the Medtronic Evolut™ heart valve:
The Edwards Sapien 3 uses a balloon to expand the valve:
Aortic stenosis is the narrowing and restriction of the opening of the aortic valve, which connects the major pumping chamber of the heart (left ventricle) to the artery connecting to the rest of the body (the aorta). It can be caused by a birth defect or rheumatic fever, but as we get older, it is frequently due to a buildup of calcium deposits on your valve. When it becomes severe, less oxygen-rich blood exits the heart. This can cause some to feel tired with only minor activity. They may also experience shortness of breath, chest discomfort, or near passing out spells.
The current standard treatment for severe aortic stenosis is open heart surgery where the valve is removed and replaced with a tissue or metallic valve. This is called conventional or surgical aortic valve replacement. During TAVR the new valve is moved into place through a tube called a catheter which is inserted into a blood vessel near the groin. Once the valve is in place, it is deployed and works right away.
People with severe, symptomatic calcified aortic stenosis who are deemed “intermediate risk”, “high risk” or “inoperable” for open-heart surgery may be good candidates for TAVR. People who are extremely sick, very petite, or who have arteries that are too small for a catheter may not be good candidates for TAVR.
As with any procedure, the TAVR procedure has risks. The risk varies by patient, depending on medical conditions and body make-up. Some risks with TAVR include, but are not limited to, reaction to anesthesia, death, stroke, damage to the artery used for insertion of the valve, major bleeding, and contrast induced kidney injury. In addition, in the United States there is only data on the first five years on the longevity of the valve’s function. Though we expect these valves to last as long as their surgical counterparts, we cannot say this with complete confidence until we have the data. Up to five years, the data is similar to surgical valves as expected.