What is TAVR, or Transcatheter Aortic Valve Replacement?
Transcatheter aortic valve replacement (TAVR) is an innovative procedure for patients with severe aortic stenosis who are not eligible for traditional open heart surgery. Available at Memorial Hermann-Texas Medical Center and Memorial Hermann Southwest Hospital, this less-invasive technology allows a new aortic valve to be placed within the diseased valve while the patient's heart is still beating.
The transfemoral delivery of the Edwards SAPIEN® transcatheter aortic heart valve was approved by the FDA in November 2011.
The TAVR technology consists of a balloon-expandable stent with an integrated bovine pericardial valve.
Most often, the valve is placed through a small puncture or incision overlying the femoral artery. For patients with small arteries, a transapical approach may be used. In these cases, the valve is delivered between the ribs of the left side of the chest directly into the heart.
How is TAVR Different than Traditional Heart Surgery?
TAVR is an innovative procedure for patients that suffer from severe aortic stenosis but are not eligible for traditional open heart surgery.
If you experience no aortic stenosis symptoms, or symptoms are mild, you may only need to be treated medically by your physician and monitored. If your doctor determines that you are too sick for open heart surgery and if medicine is not helping you feel better, aortic valve replacement may be an alternative.
Benefits of TAVR
Because the transcatheter aortic valve replacement procedure does not require open heart surgery and in most cases the patient does not need to have his or her heart stopped for the procedure, there are some significant benefits for patients who qualify for TAVR. These include fewer ICU days, shorter hospital stays and a quicker return to normal activities; significantly lower cardiac and respiratory complications; and about one-eighth the blood loss of conventional open valve repair.
Research Study: The PARTNER II Trial
The Heart & Vascular Institute-Texas Medical Center is one of only three sites in Texas involved in the PARTNER II Trial, a research study that enables our affiliated physicians to place a new smaller version of the SAPIEN® valve in patients who qualify for the procedure.
Types of Valves
Heart prosthetic valves come in different sizes to fit your anatomy and are made from a variety of materials:
- Bioprosthetic or tissue valves are made primarily from animal or human tissue
- Mechanical valves are constructed from synthetic material
The SAPIEN valve used in the TAVR procedure is a bioprosthetic valve. Different valve types have different benefits and risks. You and your doctor will choose a valve based on your individual lifestyle, age and medical condition.
Risks of Surgery
TAVR is a significant procedure involving general anesthesia. As with any surgery, placement of the Edwards SAPIEN Valve is associated with specific contraindications as well as serious adverse effects. For the TAVR procedure, these include risk of death, stroke, damage to the artery used for insertion of the valve, major bleeding, and other life-threatening and serious events. In addition, the longevity of the valve's function is not yet known.
Am I a Candidate for TAVR?
TAVR is a minimally invasive treatment option for severe aortic stenosis in high-risk patients who are not eligible for traditional open-heart surgery.
Who should schedule a screening?
- Anyone diagnosed with aortic stenosis
The TAVR procedure is not right for everyone. In certain cases, the risks of the procedure may outweigh the benefits.
Who should not consider the TAVR surgery?
- Anyone whose aortic valve is not calcified
- Anyone who has a blood clot or an abnormal growth
- Anyone who has an infection in the heart or infections elsewhere
- Anyone who already has had a prosthetic (man-made) valve implanted in any of their four heart valves, with the exception of the mitral valve
- Anyone who has aortic stenosis along with moderate or severe aortic regurgitation (when your valve does not fully close and allows blood to leak backwards through the valve)
- Anyone who has severe disease of their mitral valve requiring surgery
- Anyone whose aortic valve is either too small or too big