TAVR (Transcatheter Aortic Valve Replacement)

What is Transcatheter Aortic Valve Replacement?

Transcatheter Aortic Valve Replacement (TAVR) or Transcatheter Aortic Valve Implantation (TAVI) is a minimally invasive procedure to replace the heart’s aortic valve in patients with severe aortic stenosis. TAVR is an alternative to open-heart surgery or Surgical Aortic Valve Replacement (SAVR) for high-risk patients. 

Why do you need Transcatheter Aortic Valve Replacement?

The aortic valve is one of the four heart valves that keep the blood flowing forward. It is located between the left ventricle or lower heart chamber and the aorta. The valve allows blood to flow from the heart to the aorta and prevents the blood from flowing backward.

If the aortic valve doesn’t open correctly, blood flow may be reduced, and the body may not be able to receive enough oxygen-rich blood. The aortic valve may become stiff and couldn’t open properly, making the heart work harder to pump blood through the small valve opening. This can increase the risk of heart failure.

TAVR procedure can help restore blood flow and reduce the symptoms of aortic valve stenosis, such as shortness of breath, fatigue, chest pain, palpitation, and fainting.

Transcatheter Aortic Valve Replacement can be a better option for patients with a high risk of developing complications during an open-heart valve replacement surgery. The decision to replace the aortic valve through the TAVR procedure is made after the cardiologists, and heart surgeons evaluate the patient’s overall health.

TAVR Procedure

TAVR is a non-invasive but effective alternative to surgical aortic valve replacement. The procedure usually takes less than an hour and is done under general anesthesia or moderate sedation.

The surgeon will make a small incision in one of the following:

Groin:

to guide a catheter through the femoral artery, a blood vessel in the thigh or groin

Chest (Between the ribs):

The catheter is inserted directly into the heart through the chest and is called transapical access.

Collar bone:

to access the heart from the blood vessel under the clavicle or collar bone.

Neck:

to guide the tube to the heart through the carotid artery in the neck, known as transcarotid access.

The doctor places the catheter in the correct position using moving X-ray images or echocardiogram pictures. During the procedure, a cow or pig tissue replacement valve is inserted into the aortic valve area through a hollow catheter. An inflatable balloon at the catheter tip presses the new valve in place. Valves can expand without a balloon in some cases.

The catheter is removed once the new valve has been securely placed. As part of the TAVR procedure, your vital signs are closely monitored, including blood pressure, heart rate, and rhythm.

Types of Replacement Valves

The replacement valve can be biological or mechanical.

Mechanical valve

These valves are made of metal, polyester, or ceramic materials. These artificial valves can last for 20 to 30 years. However, mechanical valves involve the risk of blood clot formation around them. The patient must take blood thinners to avoid blood clotting and prevent stroke.

Biological Valves

Biological valves or bioprosthetic valves are made of human or animal tissues. There are three types of biological heart valves.

• Allograft or homograft: Heart tissue from a human donor is used for the valve.
• Porcine valve: Made from pig tissue, it is implantable with or without a stent. The tissue is treated before implantation to avoid a negative immune response.

Book an appointment with us today to get a consultation from our heart specialists.

Benefits of the TAVR procedure

TAVR is now the most commonly used procedure for replacing an aortic valve because of its several benefits over open-heart valve replacement surgery. Some of the benefits of TAVR are:

Minimally invasive

TAVR is less invasive than surgical aortic valve replacement. During the open surgery, the surgeon makes a larger incision to spread open the rib cage to access the heart. TAVR procedure is minimally invasive and requires only a small incision to insert the catheter to replace the heart valve.

Faster recovery

As the incision size is smaller, the body requires less time to heal the wound. Additionally, the chest structure is less traumatized, and the patient will experience less pain than someone who has undergone open-heart surgery . Patients getting a TAVR can return to their routine more quickly.

Lower risk of complications

There are fewer complications associated with the TAVR procedure than with open-heart surgery. Since TAVR doesn’t require the heart to be stopped, the patient is not put on a cardiopulmonary bypass machine, which otherwise increases the risk of complications like arrhythmia and stroke.

Better outcomes in high-risk patients

TAVR is more likely to be successful and does not cause major complications in high-risk patients. It is a safer alternative to open-heart surgery for people with a higher risk of developing complications or those who cannot undergo open-heart surgery due to other medical conditions.

Risks and complications of TAVR

As TAVR is a minimally invasive method, complications associated are rare. The risk of developing complications depends on the patient’s overall medical health and how well the patient follows recovery instructions. Some possible complications from TAVR include:

• Disruption in the heart’s electrical system that may require pacemaker implantation.
• Some patients may develop a paravalvular leak in which blood may leak from the outer edge of the valve.
• Low blood pressure
• Bleeding

Patiala Heart Institute is the leading cardiac care hospital offering elite healthcare services to its patients. Our highly qualified cardiologists and heart surgeons specialize in providing the best treatment for any cardiovascular disease.

Book an appointment with us today to get a consultation from our heart specialists.