Transcatheter Aortic Valve Replacement (TAVR)

Until recently, surgical aortic valve replacement or SAVR was the only treatment option for patients suffering with severe aortic stenosis. However, many patients with severe aortic stenosis have other medical conditions that keep them from being good surgical candidates. 

In 2014, Premier Health’s structural heart team was proud to be the first in Dayton to introduce another option called transcatheter aortic valve replacement (TAVR). As its name implies, TAVR technology is a nonsurgical, catheter-based intervention that can deliver and position a fully expandable, bioprosthetic replacement aortic valve while the heart is still beating. TAVR eliminates the need for a long incision in the chest wall, makes the use of a heart-lung bypass machine unnecessary, and provides a shorter, more comfortable recovery period when compared to a surgical replacement. 

The Premier Health TAVR Team, composed of specialists and staff from across the region, is experienced in both surgical aortic valve replacement and the nonsurgical TAVR procedure. The team, which conducts the procedures at Miami Valley Hospital, includes a certified nurse specialist who assists with preoperative testing, postoperative care, and patient follow-up.

Originally, the U.S. Food and Drug Administration approved TAVR for patients with severe, symptomatic aortic stenosis who were at high risk for open-chest surgery – and often refused or were denied surgery. In 2016, the FDA expanded its approval of TAVR to include patients at intermediate surgical risk. This allows Premier Health to offer more patients with aortic stenosis new hope for an improved quality of life. 

The TAVR Procedure

Our team is trained and experienced in performing TAVR using a variety of approaches: 

  • Transfemoral: A small incision is made in the groin, and entry into the circulatory system is through the femoral artery. This is the approach used most often. 
  • Subclavian: A small incision is made in the upper chest near the collar bone and entry into the circulatory system is through the subclavian artery. 
  • Transaortic: A small incision is made in the upper chest to access the diseased aortic valve.
  • Transapical: Uses a small incision between the ribs to access the lowest part of the heart.

Assisted by advanced imaging techniques and technology, the team gently guides and places the device-carrying catheter between the heart’s left ventricle and aorta. The aortic valve that is being replaced is not removed, but instead serves as an anchor for the new TAVR valve. Once in place, the replacement valve is deployed, the catheter is gently guided out, and the TAVR procedure is finished. 

TAVR can be performed using monitored anesthesia care and generally takes less than two hours. 

TAVR Patient Benefits

TAVR is not without risk, but it offers a beneficial treatment option for people who may not be candidates for surgical aortic valve replacement. Often, TAVR patients describe their experience as comparable to coronary angioplasty. 

In most cases, benefits of TAVR include:

  • A shorter hospital stay with fewer complications, less discomfort, and a faster recovery than with surgical aortic valve replacement. Recovery from a surgical replacement, with an open-chest incision, generally requires four to eight weeks.
  • Improved quality of life by easing the signs and symptoms of aortic stenosis, such as pain or pressure in your chest, dizziness, shortness of breath, and extreme fatigue 
  • Frequently, a return to regular activities with noticeable improvement after recovery. We ask TAVR patients to talk with their health care provider before starting any exercise program. 

About Aortic Stenosis

Aortic stenosis is one of the most common and serious heart valve diseases. When the aortic valve is unable to open wide enough to allow adequate blood flow from the left ventricle to the body, the heart is forced to work harder to compensate. This added workload will eventually wear out the heart. 

About 2.5 million Americans age 75 or older have aortic stenosis. After the onset of symptoms, and without an aortic valve replacement, patients have a survival rate as low as 50 percent at two years and 20 percent at five years. 

The signs and symptoms of aortic valve stenosis include chest pain, lightheadedness, dizziness, fatigue, and shortness of breath. Eventually, severe aortic stenosis can cause the heart to weaken, increasing the risks of heart failure, sudden cardiac arrest, and death. 

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Miami Valley Hospital: (937) 208-5448(937) 208-5448