TAVR: A Modern Approach to Valve Replacement

What Is an Aortic Valve?

Your heart has four valves to help blood flow in the right direction. Healthy valves open and close properly so that blood does not flow backward between chambers.

The aortic valve is one of these four valves, preventing the backflow of blood from the aorta to the left ventricle. When a diseased aortic valve does not function properly, it requires the heart to pump harder to ensure enough blood supply reaches the rest of the body. Aside from stenosis (narrowing), other conditions affecting the aortic valve include:

• Prolapse – this happens when the valve’s leaflets do not correctly close
• Regurgitation – this occurs when blood leaks backward through the valve

What Is TAVR?

Transcatheter aortic valve replacement (TAVR) - also known as transcatheter aortic valve implantation (TAVI) - is a surgical treatment for dysfunction of the aortic valve. It may be recommended to patients diagnosed with structural heart disease.

One appeal of TAVR surgery is that it is minimally invasive, meaning it requires smaller incisions than traditional surgery. This typically results in less scarring, quicker recovery times, and less overall pain for patients.

During TAVR, a small, thin tube called a catheter is inserted through an artery and guided toward the damaged heart valve. The damaged valve is then replaced with a new, functional valve implant.

Who Qualifies for the TAVR Procedure?

Generally, TAVR benefits patients with severe aortic stenosis, meaning their aortic valve has narrowed significantly, resulting in restricted blood flow from the left ventricle to the aorta.

Symptoms of aortic stenosis include:

• Chest pain
• Difficulty sleeping
• Fluttering or rapid heartbeat
• Lightheadedness
• Swollen feet or ankles
• Trouble breathing

Before proposing TAVR, your doctor will evaluate your medical history, lifestyle, and various test results to ensure you’re a good candidate. If your heart is too weak to undergo surgery, you have other untreated heart conditions, or have had a recent heart attack, your doctor may propose an alternative treatment plan.

What to Expect During the Procedure

The TAVR procedure may take up to 90 minutes to complete, compared to traditional open-heart surgery which may take up to four to six hours.

During these 90 minutes, as previously mentioned, a catheter is used to access your damaged valve and replace it with a valve implant. This valve implant will help regulate blood flow. Typically, your doctor will approach the procedure in one of two ways:

• Transfemoral: the surgeon accesses the damaged valve through the femoral artery instead of a chest surgical incision.
• Transapical: a minimally invasive procedure where a surgeon makes a small cut in the chest and enters the heart through its apex.

What Is a TAVR Valve Made Of?

You may be wondering what exactly a ‘valve implant’ looks like, and its general structure.

A TAVR replacement valve is typically made from two main components:

• Tissue leaflets: These thin flaps within the valve control blood flow. They are most commonly made from biological tissue from an animal.
• Valve frame: This supportive structure holds the leaflets in place. The frame is usually made from durable metal such as:
  • Nitinol: This shape-memory alloy is commonly used in TAVR valves due to its flexibility and ability to conform to the heart's anatomy during implantation.
  • Stainless steel: In some cases, stainless steel might be used for the frame, although nitinol is generally preferred due to its flexibility benefits.

Recovering After a TAVR Procedure

The wound from the TAVR catheter incision site may take about two weeks to heal. Follow your doctor’s instructions for dressing, covering and keeping the wound dry. At the end of the two weeks, your doctor may need to remove the wound staples or stitches.

Even after stitches and staples are removed, your incision site may remain bruised for a few weeks. Contact your doctor if your wound is swollen, feels warm, is bleeding, draining excess fluid, or reopening.

Your doctor will also prescribe certain medications to ward against blood clots during your recovery, as clots can lead to stroke or heart attacks. Generally, TAVR patients are expected to maintain a heart-healthy, low-salt, low-fat diet moving forward.

Find a Heart Valve Specialist in El Paso, TX

Dr. Tariq Siddiqui has over two decades of experience in minimally invasive interventions for heart disease. He can guide you through the entire TAVR process, beginning with initial evaluation and diagnosis of heart valve disease, all the way through post-op recovery.

To learn more or to book an appointment, please call (915) 271-4652.