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Transcatheter Aortic Valve Replacement (TAVR)

Structural Heart and Valve Doctors at Baptist Health

Baptist Health is known for advanced, superior care for patients with heart conditions and the diagnosis, treatment and management of valvular heart disease. You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of doctors and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

What Is Transcatheter Aortic Valve Replacement (TAVR)?

Traditionally, when a person is diagnosed with aortic stenosis, open heart surgery was the only option to treat this disorder. Less invasive valve replacement options are now available to treat disease aortic valves. Transcatheter aortic valve replacement (TAVR) was initially approved by the FDA in 2011 as an alternative to open heart surgery in patients who were high risk for surgery. Continued advancements in this technology and excellent results allowed for FDA approval for its expanded use in most patients who are deemed good candidates by the Baptist Health heart team.

The TAVR procedure involves an Interventional Cardiologist and Cardiothoracic Surgeon working together to replace the aortic valve using catheters through a small incision from the leg artery or in the chest wall. Two devices currently used are the Edwards Sapien 3 and Medtronic Evolute valves platforms, which are commercially available. Unlike traditional surgery the heart is not stopped or put on bypass machine, which has resulted in shorter hospital stays and quicker recovery times.

For more information, contact Baptist Health or schedule an appointment with one of our heart care doctors today.

What Can TAVR Accomplish?

After a TAVR surgery, proper blood flow and circulation is restored to your body, giving you more energy. It can also:

Reduce or eliminate heart murmurs or palpitations
Reduce or eliminate swelling in feet and legs
Reduce or eliminate chest discomfort or pain
Enable you to be more physically active without experiencing fatigue or shortness of breath

What Can I Expect During the Procedure?

One of the biggest benefits of TAVR is that it requires only a few small incisions. Those incisions are typically made in groin or neck to access the artery and place a large IV or sheath. Through the sheath a valve is then advanced across the native diseased valve over a wire. The valve is then deployed either by inflating a balloon to expand the valve or allowed to expand after removing a sheath. The native valve is left in place and is used to secure the new TAVR valve in position. This procedure can be done either with the patient asleep on the ventilator or under moderate sedation.

Recovery

Your recovery will depend heavily on your condition before the procedure, and the type of sedation and procedure performed. Recovery often involves an overnight observation on a telemetry floor but further observation may been needed to monitor any heart rhythm issues or other unforeseen issues. Patients are able to get back to the prior activity with minimal restrictions after leaving the hospital and are recommended to attend cardiac rehabilitation which can be done at Baptist Health or locally.

Estimated Recovery Timeline

Many people feel relief of symptoms almost immediately. You will tire easily in the days following hospital discharge, but your energy will increase as you heal. Make sure to keep your follow-up appointments and follow instructions for heart-healthy eating and exercise.

Heart Valve Repair Possible Risks

Any medical procedure carries risks, but heart valve repair is typically a safe and effective procedure. You will be given instructions about how to avoid these specific risks, as well as what to do if you experience these issues after your procedure:

Blood clot or damage to the blood vessel at catheter insertion sites
Significant blood loss that may require blood transfusion
Infection
Abnormal heart rhythms
Stroke
New or worsening valve regurgitation
Rupture of the valve
Pneumonia

View Hide Transcript

♪ [music] ♪

- [Joan] We were assigned to the same
homeroom, I think.

Weren't we?

- [Tom] Yes, 7201B
Highland Junior High School.

I remember the senior play.

I became Dr. Bradley,
and Joan was working with props.

- I brought one of the prop stand.

I looked up to him and he said,
"I know. I like you, too."

- And we had three children by
the time we were 27.

It was early April.
Just like most people, I cut the grass.

And after a couple of passes,
I was totally out of breath.

So I came and sat down for a few minutes,
got back up, and the same thing happened.

I said, "This is totally unusual."

I'm there in Louisville Cardiology.
They give me the echocardiogram.

I had a valve that was
almost open only to a pinhole.

I was scheduled for May 1st
a heart catheterization,

and Dr. Christopher Semder did that.

And he stood at the
head of my bed afterwards.

He said, "Tom, you've got a golden heart,"
that's the word he used,

"except your aortic valve is a disaster
and it has to come out.

It has to be replaced.

We're going to see if you're ineligible
for a TAVR surgery."

- [Linda] TAVR is just the acronym for
transcatheter aortic valve replacement.

It allows the physicians to replace their
native aortic valve with a tissue valve.

- And my thought was, well, yeah,
we need to deal with this because I've got

a wedding coming up here.

- We have nine grandchildren.
We just have one boy.

- So it became critically important for me
to know whether I was eligible for that

procedure and, if so,
that that procedure could be done

as soon as possible.

- [Dr. Semder] Tom is a gentleman
who had other medical issues

that made him an excellent
candidate for transcatheter

aortic valve replacement.

He recovered very quickly and was out of
the hospital within one to two days.

- With this wedding as the big goal for
us, we were rallying.

We were going to get him back on his feet
and feeling good back to his family so he

could enjoy that wedding.

- Linda was the face of it all.

She has the skill to build trust quickly.
She understands your needs.

She's a real person that you're going to
see and is going to stay with you from the

very first time to the very last time.

And you're never going to be alone.

- I just appreciate so much feeling like a
human being just not another widget.

And this is my husband,
and he is important to me.

- [Dr. Pagni] [inaudible]
his size of incision.

He has to do the experience the patient
had, the management of pain after surgery,

what is the relationship the patients have
with the ancillary service in terms

of nursing staff, coordinators,
social workers, and how at the end,

when the patient go home,
and after a month, they think, "Well,

how was my experience there?"

- The best thing that gave me confidence
was that there was a team of doctors.

- We're at the forefront of new
technologies and new procedures.

I think that this procedure especially
really allows for a dramatic improvement

in symptoms but also in what these
patients are able to do at home.

- They have the staff there not only to do
it medically but they have the staff there

to make it feel really okay.

You think of yourself, you know,
where you were helpless just trying to get

a breath, you know, after doing a mild
task of some sort and then all of a sudden

you're able to be well enough to not only
enjoy this special event with them

but to be there in person
and be engaged and holding them,

sharing their moment together,
that was everything.

The thing I like about Baptist is,
"Mission Impossible.

Here we go. Let's make it happen."

♪ [music] ♪

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