Your heart is your lifeline, essential to the functioning of your body. By pumping oxygen-rich blood throughout your body, it allows you to live a healthy life. The valves in your heart have two important functions — they open so that blood can empty from the heart’s chambers, and they close so that blood cannot flow back the wrong way.
People with aortic stenosis — a condition where the aortic valve narrows— have difficulty getting blood to flow from the heart to the rest of the body. This can be caused by birth abnormalities, related to age, or related to another condition like an injury. It can cause symptoms like chest pain, shortness of breath, fatigue, fainting, and heart murmurs — and it can put you at a higher risk for heart failure.
Up until the early 2000s, there was really only one treatment option for those with severe aortic stenosis: open-heart surgery for a total aortic valve replacement. Fortunately, a solid, alternative option has emerged: transcatheter aortic valve replacement, or TAVR. Rather than replacing the old valve, the procedure puts a new, functioning valve within the old valve.
TAVR — an alternative to open-heart surgery that minimizes incisions and trauma to the body — can fully restore your heart’s function by having a new valve take over the job of the old valve, fully restoring blood flow throughout your body.
6 Key Terms to Explain TAVR
Aortic stenosisThis is a condition in which the heart’s aortic valve becomes narrow. This makes it harder for the heart to pump blood to the rest of the body. Aortic stenosis can cause chest pain, shortness of breath, and fatigue.
Aortic valveIt’s one of four main valves in the heart. The aortic valve separates the lower left chamber (ventricle) of the heart and the aorta (one of the major arteries in the body). Each heart valve must open and close properly so that blood can flow in the right direction through the heart and body.
Surgical aortic valve replacement (SAVR)SAVR is the traditional procedure for a total replacement of the aortic valve, which requires open-heart surgery.
Transcatheter aortic valve replacement (TAVR)TAVR is a minimally-invasive alternative to a standard aortic valve replacement for patients with severe aortic stenosis that involves using a catheter to place a new valve over the old one.
Cardiothoracic SurgeonThese physicians specialize in surgeries of the heart, lungs, esophagus, and other organs located in your chest, and they are trained to perform a transcatheter aortic valve replacement.
Interventional CardiologistA physician who specializes in catheter-based procedures to manage and treat heart disease.
Is TAVR Right For You?
TAVR may be a good option when open-heart surgery is too risky, such as if you’re:
- Age 70 or older who have other medical conditions, such as diabetes, lung disease, or kidney disease
- Younger than 70 who have medical devices in their hearts from previous open-heart surgeries, which can cause complications
- Someone whose chest wall is compromised by another heart condition, such as chest wall abnormalities or infection
The procedure may be done for a couple of reasons. It may be recommended if you are experiencing changes in your aortic valve that are causing major heart problems — including chest pain, shortness of breath, fainting spells, fatigue, or heart failure — or if tests show your aortic valve is seriously harming how well your heart works.
About The Procedure: 4 Steps Of TAVR
- TAVR is done in a hospital. You will be given general anesthesia or conscious sedation.
- A catheter — a long, thin tube — will be inserted through a tiny opening in a blood vessel, typically in the groin. In some cases, the catheter may be inserted into the chest, ribs, or collarbone.
- Your physician will guide the new aortic valve into place with the catheter and deploy the new valve. It does not remove the existing valve, but assumes the job of the old valve.
- The catheter will be removed, and your incision will be closed with stitches. The procedure takes about 1 to 2 hours total.
TAVR: A Promising New Procedure
- 50,000 TAVR procedures have been performed in the US since 2011.
- TAVR provides the same outcome with less pain, blood loss, and chance of infection.
- TAVR patients have a lower risk of stroke, heart attack, and major bleeding.
- TAVR leads to a quicker recovery compared to open-heart surgery.
A Safe, Quick Recovery: How To Prepare
Make sure your physician knows about all medications you’re taking — including prescriptions, over-the-counter medications, supplements, and herbs. The goal is to make sure none will cause any harmful side effects during or after the procedure.
It’s also recommended that you visit your dentist to ensure you don’t have any infections in your mouth. If untreated, these infections may spread to your heart or the new valve.
For about 1 week prior to the procedure, you will likely be asked to stop taking medications that can make it harder for your blood to clot — like ibuprofen and naproxen — which might cause bleeding during the procedure. Other blood-thinning medications — such as warfarin — may need to be stopped or simply altered. Do not make any changes to your medication regimen without first discussing these changes with your physician.
During the days before your procedure, you will need to stop smoking. It’s also important for you to let your physician know if you get sick prior to the procedure. Being ill can cause complications during the procedure.
Your physician will ask you to take a few preventative measures to avoid infection. The day before your TAVR procedure, be sure to shower and shampoo well. You may be given a special soap prescribed by your physician to use at this time.
You will be asked to not eat or drink anything — including chewing gum — after midnight the night prior to your procedure. If your physician prescribes any medications, you can take these with a small sip of water.
Recovery In the Days, Weeks, and Months Following Your TAVR Procedure
- Immediately after: Your physician will encourage you to get up, breathe deeply, and resume basic activities like eating, drinking, and walking. You will likely spend 1 to 3 days in the hospital.
- First few days and weeks after: You should gradually regain energy and resume activities as prescribed by your physician.
- Follow-up care:
- You will have a 1-week post-operative appointment for a checkup and clearance to resume normal activities.
- You will also have a 1-month post-operative appointment with an echocardiogram to assess the new aortic valve.
Ways to speed up recovery
- Eat a heart-healthy diet — like fruits, vegetables, whole grains, lean meats, and low-fat dairy products
- Stay active, making sure you work at a pace that’s right for you and your individual recovery
- Follow your physician’s post-op recovery instructions — and don’t hesitate to let them know if you are struggling with any aspect of recovery
Why Choose Stormont
Located in Topeka, Kansas, Stormont Vail Health is a community-driven organization. It offers close to home care and with limited travel requirements, it will be easier for you to get the care you need in a community you trust.
In 2009, Stormont Vail achieved Magnet designation, one of the highest awards in nursing excellence and high-quality patient care. Only 9% of US hospitals have earned this recognition.
The Joint Commission — with more than 50 years of accrediting hospitals in high quality standards — has accredited Stormont Vail Hospital. Stormont also achieved additional accreditations in many areas, including Advanced Primary Stroke Center and Chest Pain.
Stormont Vail has the experienced and skilled medical team for your TAVR procedure.
Make an Appointment
To make an appointment at the Cotton O’Neil Heart Center, call (785) 270-4000.