What does the TAVR procedure involve?

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Also known as transcatheter aortic valve implantation (TAVI), this is a minimally invasive procedure that can treat aortic stenosis. This refers to a condition that narrows the heart’s aortic valve, which can restrict blood flow from the heart to the rest of the body.

The TAVR procedure involves inserting a new valve through a catheter to replace an aortic valve that is no longer working properly.

TAVR is typically an option for individuals experiencing symptoms of severe aortic stenosis. This may include symptoms such as:

• chest pain
• trouble breathing
• feeling lightheaded
• rapid heartbeat
• swollen ankles or feet
• reduced ability to perform normal activities
• difficulty sleeping
• difficulty walking short distances

If a cardiologist, or heart doctor, recommends heart valve replacement surgery, they will consider factors such as a person’s age, their health, the severity of their symptoms, and the potential risks of surgery.

A doctor may recommend TAVR as an option for individuals who are at high risk or deemed ineligible for open heart surgery to replace the valve. This is because the TAVR procedure does not require doctors to stop the heart and it avoids making a large incision in the chest. As such, this places less strain on the body.

Originally, TAVR was an alternative option for those who might not be suitable for other surgical options. However, experts indicate that it is an effective option that is now available for people in all risk categories.

A 2023 study suggests that the minimally invasive TAVR procedure can provide a superior clinical outcome compared with open heart surgery over a 3-year follow-up period. A person is also likely to spend less time recovering after TAVR than they would for open heart surgery.

Read on to learn more about other surgical options to replace a heart valve.

The TAVR procedure is a similar process to placing a stent within an artery to reduce narrowing. This is because it involves using expandable material to help restore blood flow.

There are different ways a doctor can perform the TAVR procedure, depending on a person’s health and the health of their blood vessels. The most common approaches use either the femoral artery, which is in the groin, or transapical access, which uses blood vessels in the chest. If these arteries are too small or damaged, a doctor may instead use blood vessels in the stomach, collar bone, neck, or septum.

After identifying a suitable blood vessel, the surgeon will make a small incision to access the blood vessels and insert a balloon catheter. This is a small, flexible tube. The surgeon will then thread the catheter with the replacement valve, which usually consists of metal or animal tissues, through the blood vessel and guide it to the aortic valve.

Once in position, the balloon catheter will inflate to expand the replacement valve into the aortic valve’s space. The replacement valve will begin functioning immediately to help regulate blood flow.

Typically, a team of cardiologists and cardiac surgeons will perform the TAVR procedure in a hospital. The TAVR procedure will usually take 1–2 hours. Prior to the procedure, the team will measure the valve opening and provide a sedative and local anesthetic. They may also administer medications to prevent blood clots.

During the procedure, the healthcare team will closely monitor the individual using a heart monitor. They will check a person’s heart rate and rhythm, as well as oxygen levels and blood pressure.

After guiding the catheter to the aortic valve and securely placing the replacement valve, the team will check for any leaks or other possible complications. They will then remove the catheter.

Depending on the approach the surgeon uses, a person may need to stay in hospital for a few days. Following the procedure, the care team will transfer the individual to a recovery area.

During the hospital stay, the cardiac care team will conduct follow-up tests, such as an X-ray, electrocardiogram, and echocardiogram. These tests can help monitor the heart and ensure it is functioning properly.

Potential risks following the procedure include:

• damage and bleeding at the insertion site
• injury to the kidneys or heart
• leaking in the new valve
• requirement for a permanent pacemaker
• stroke

Before leaving the hospital, the healthcare team will provide information on a cardiac rehabilitation program. This program aims to reduce symptoms, increase function, and improve quality of life. It will typically cover topics such as diet, exercise, caring for wounds, and how to take any new medications.

After discharge, a person will need to attend regular checkups to ensure the valve is functioning correctly and detect any potential problems early.

TAVR recovery is typically much faster than recovery from other options, such as open heart surgery. Most individuals can resume normal activities within 2 weeks. However, recovery can vary, and it may take 6–10 weeks for a person to fully recover.

TAVR, or TAVI, is a minimally invasive procedure that can treat narrowing of the aortic valve. The procedure involves the insertion of a replacement valve to help regulate blood flow.

It can be a suitable option for individuals at higher risk of complications from other approaches, such as open heart surgery.