TAVR procedure helps people with severe aortic stenosis breathe easier

Some patients with aortic stenosis (AS), a narrowing in the opening of the aortic heart valve, might be at risk for serious and life-threatening dangers. About 2.5 million people in the United States who are 75 or older have aortic stenosis, which forces the heart to work harder and can disrupt the flow of oxygen-rich blood to the body. Severe AS can lead to heart failure.

While open-chest surgery is the traditional way to repair the valve, patients who cannot undergo surgery may benefit from a minimally invasive procedure known as transcatheter aortic valve replacement (TAVR).

Since the initial approval of TAVR for inoperative patients in 2011, there have been series of clinical trials. Now, TAVR has also been approved by the FDA for patients who are at low risk for surgery by FDA in 2019. 

“TAVR is a very reasonable option for a wide range of patients, from those who are not surgical candidates due to comorbidities to those who are at low risk for surgery,” said Dr. Naoki Misumida, interventional structural cardiologist at UK HealthCare’s Gill Heart & Vascular Institute.

“TAVR is less invasive that conventional surgery. The aortic valve can be replaced without the need for full sedation, and no breathing tube is required,” Dr. Misumida said. “Most patients are up walking in the hallway later on the day of the procedure, and most go home the next day. Many patients tell me they immediately notice an improvement with their symptoms."

The UK Gill Heart & Vascular Institute offers the most complete and most experienced transcatheter valve program in the region. 

Here’s what you need to know about aortic stenosis, its symptoms and the TAVR procedure:

Who is at risk for AS?

AS mainly affects older people, usually starting after age 60, but symptoms might not appear until after 70. Younger people may have AS as result of a congenital defect.

What are the symptoms of severe AS?

People with AS might not experience noticeable symptoms until the condition becomes acute. Symptoms include:

• Shortness of breath.
• Swelling in feet and ankles.
• Dizziness.
• Syncope or near syncope.
• Fatigue.
• Chest pain.

Who can undergo a TAVR procedure?

In many cases, open-chest surgery can repair heart valve problems. But to get to the heart, surgeons must cut through tissue and bone. This can be too risky for some patients.

For these patients, TAVR might be an option.

How does TAVR work?

The TAVR procedure is performed under the care of multidisciplinary heart team that includes a cardiologist, cardiac imaging specialist and heart surgeons.

The new heart valve is placed on a catheter that is then advanced to the aortic valve. With the assistance of an inflated balloon, the new valve expands into place. The existing valve holds the new valve in place. Once the new valve is inflated, the balloon is deflated and removed. The new valve will immediately begin to open and close.

A patient might go to the ICU post-procedure but generally goes to a progressive unit for overnight monitoring and can go home the next day.