Transcatheter Aortic Valve Replacement (TAVR)

What is Aortic Stenosis?

Aortic stenosis is a condition in which the aortic valve, the main valve connecting the heart to the rest of the body, does not open fully due to thickening of the valve leaflets. Valve disease can occur for several reasons, but age-related factors are the most common in the United States.

This leads to significantly increased load and work on the heart muscle and reduced blood flow to the rest of the body. Over time this can lead to symptoms of increased fatigue, decreased activity tolerance, chest discomfort, difficulty breathing, lightheadedness, dizziness and fainting.

A multidisciplinary team can provide a comprehensive evaluation to determine the optimal timing and treatment options for each patient depending on aortic stenosis severity and symptoms.

Once treatment is indicated, severe aortic stenosis can be treated with either minimally invasive (transcatheter) valve replacement or open surgical valve replacement.

What is the TAVR Procedure?

Transcatheter Aortic Valve Replacement, or TAVR, is a minimally invasive, catheter-based procedure to replace the diseased aortic valve in patients with severe aortic stenosis. Previously, the only treatment for aortic stenosis was open-heart surgical aortic valve replacement surgery (SAVR).

Over the past years, TAVR has been shown to be as effective as surgical aortic valve replacement in the treatment of severe aortic stenosis in most patients, and has rapidly become the treatment of choice for many patients.

Performed in the Cath Lab or Hybrid Operating Room by a team led by an interventional cardiologist and a cardiac surgeon, TAVR uses a catheter to deliver a new prosthetic valve to the heart.

The valve can be delivered via several approaches depending on the team’s recommendation. The most common approach involves access via a blood vessel in the patient's groin (femoral artery). Once the new valve is perfectly positioned, it is opened, pushing aside the flaps of the original defective valve and effectively replacing it.

This procedure is also effective in the treatment of previously replaced failing tissue (bioprosthetic) surgical valves.

An Individualized Heart Team Approach

Our multidisciplinary team consists of interventional cardiologists, general cardiologists, cardiac imaging specialists, cardiac surgeons and cardiac anesthesiologists. Our team also includes advance care practitioners and a nurse clinical coordinator who help provide individualized care at every step of the evaluation and treatment process to achieve outstanding outcomes for our patients.

Who is a Good Candidate for TAVR?

Our Heart Team provides an extensive evaluation which culminates in a multidisciplinary discussion to determine individualized treatment options and can make recommendations with regards to the best treatment options.

Recent studies have shown benefit across the spectrum of surgical risk (low, intermediate, high and prohibitive risk for open heart surgery). As such, TAVR is now approved and shown to highly benefit patients regardless of their risk open heart surgery. The decision on the best treatment option now is based on individual patient factors and shared-decision making between the team and patient. While open heart surgery can’t always be avoided, we anticipate that TAVR will become the standard of care for all aortic stenosis patients in the near future.

Like all procedures there are certain risks associated with transcatheter aortic valve replacement. Talk to your cardiologist to discuss the potential risks and benefits and help decide if this procedure is right for you.

Cost and Coverage

Medicare, as well as the majority of insurance providers, will cover the TAVR procedure for patients who meet appropriate coverage criteria.