Transcatheter Aortic Valve Replacement (TAVR)

TAVR is a minimally invasive way to replace diseased aortic valves and failed artificial aortic tissue valves. Find out if you or a patient may be eligible for TAVR. In the Sacramento/Central Valley area, call (916) 887-4242 and in the Bay Area call (877) 283-2873.

Oxygen-rich blood flows from the left lower chamber (ventricle) of the heart into a large blood vessel called the aorta. The aortic valve is the gatekeeper between the left ventricle and the aorta, allowing oxygenated blood to flow out of the heart and stopping the backflow of blood into the heart.

A diseased aortic valve may lead to fatigue, shortness of breath, lightheadedness, dizziness, fainting, an irregular heartbeat, chest pain, congestive heart failure and even sudden death.

You may need aortic valve surgery if:

• Your aortic valve does not close fully, so blood flows back into the heart. This is called aortic regurgitation and over time weakens the heart muscle.
• Your aortic valve does not open fully, limiting the amount of oxygenated blood flowing out of the heart. This is called aortic stenosis and reduces the supply of oxygen and nutrients to your body.

A Nonsurgical Solution

Historically, fixing a diseased valve required open-heart surgery. However, doctors throughout the Sutter Health network perform an innovative and less invasive procedure called Transcatheter Aortic Valve Replacement (TAVR).

During TAVR, your doctor places a thin, flexible tube called a catheter through a small cut into a large blood vessel in your groin or chest and inserts a large catheter for access to your heart. A guidewire fed through the catheter goes up to the heart and through the diseased aortic valve. Another catheter with a balloon on the end is fed over the guidewire. The balloon inflates inside the damaged valve to expand and make room for the new bio-prosthetic valve.

Next, a catheter delivers the replacement valve via the guidewire. When deployed, the new valve pushes the leaflets of the old valve out of the way and begins working right away. Throughout the procedure the doctor views images of your heart by X-ray.

Once the new valve is working, your surgeon will:

• Remove the catheter and guidewire.
• Check for leakage of blood leakage around the new valve.
• Check for any damage to the blood vessels used to access your heart.
• Perform an echocardiogram to check for symptoms and pressure inside your heart.
• Close the small incision in your groin or chest.

Advantages of TAVR

• Uses a less invasive procedure that eliminates need for open-heart surgery.
• Eliminates use of a heart-lung machine (cardiopulmonary bypass) during the procedure.
• Reduces infection risk.
• Takes approximately two hours from prep to recovery area.
• Reduces hospital stay, with discharge the next day.
• Allows physical activity such as walking approximately six hours after the procedure.
• Yields a shorter recovery period of about one to two weeks.
• Improves overall symptoms, quality of life and life expectancy.

Details on the Bio-prosthetic Valve

The doctors in the Sutter Health network currently use bio-prosthetic valves manufactured by Edwards and Medtronic. Your heart team will decide which bio-prosthetic valve is right for you based on the shape, size, structure of your heart and access blood vessels.

The Edwards SAPIEN 3 transcatheter heart valve, available in four sizes, features three tissue leaflets made from cow tissue. The metal frame is a cobalt chromium with a nickel alloy, so notify your doctor if you have a nickel allergy.

The Medtronic heart valve frame, also available in four sizes, is made from a nickel-titanium alloy. The valve leaflets and the outer wrap are made from pig heart tissue.