The Saint Francis Heart and Vascular Institute provides an alternative treatment option to traditional open heart surgery for patients presenting with severe aortic stenosis. Our highly-skilled cardiology team will help determine if you would benefit from having a transcatheter aortic valve replacement (TAVR).
You Have Aortic Stenosis
This is a condition involving the aortic valve, which is one of several valves in the heart. Over time, the valve stiffens and cannot open enough to let blood through. This may cause several different symptoms. Most commonly it causes congestive heart failure with shortness of breath and fluid retention. It may also cause episodes of chest pain, fainting or feeling faint. While there are medications that may help with some of the symptoms, there is no medication to make the valve work better. For many years, the only effective way to treat severe aortic stenosis has been with open heart surgery. During this surgery the valve is removed and replaced with an artificial valve. This is called conventional aortic valve replacement and requires opening the chest cavity. During the procedure the patient is connected to a heart-lung bypass machine to pump blood around the body while the heart is stopped temporarily to put in the artificial valve.
Conventional aortic valve replacement is an excellent procedure and the artificial valves usually work well for many years. Doctors have many years of experience with this surgery and generally the outcomes are excellent. For many reasons though, some patients are at high risk for complications from the surgery.
What is TAVR?
Over the last several years, a procedure has been developed to allow a valve to be placed without having to open the chest. This procedure is called transcatheter aortic valve replacement (TAVR). Transcatheter means that catheters, or hollow tubes, are used to place a new valve inside the heart instead of opening the chest. The doctors make a small opening in the artery, either from the groin or chest area, and thread the catheter and the new valve into the right position. The TAVR procedure is minimally invasive and is done without using the heart-lung bypass machine that is needed for conventional aortic valve replacement.
Your TAVR Assessment
Your appointments are scheduled over multiple days due to the various tests and amount of information needed. Our Valve Program coordinator will meet with you to ask questions about your everyday life. A walking test and a thinking test will be performed and pictures will be taken for your file.
What you should bring:
- a list of medications you are currently taking
- a list of questions you and your family have about TAVR
Our coordinator will also talk to you about how the team makes a TAVR recommendation and what you need to know about the surgery. He or she will then answer any questions you and/or your family may have.
As required by Medicare and the Food and Drug Administration (FDA), you will need to meet with two cardiovascular surgeons on different days. They will review your chart, examine you, then provide additional detailed information about how the TAVR procedure is performed. The doctors will give you information about the benefits of the procedure as well as the potential risks and complications. They will talk to you about TAVR as well as the possibility of a conventional aortic valve replacement.
You will receive the following tests during the TAVR assessment:
- Cardiac echocardiogram (Echo)
- Cardiac angiogram (Cardiac cath)
- Computed tomography (CT scan)
- Carotid doppler
- EKG
- Pulmonary function test
What Happens Next?
The TAVR team will discuss all the information we have about you, your heart and your general health. A recommendation will then be made as to the best treatment option for your aortic stenosis.
Depending on your case, the best option could be one of the following:
- Medical management - This means your family doctor or cardiologist will continue to treat your aortic stenosis with medicine.
- Conventional aortic surgery - If conventional open heart aortic valve replacement has been determined to be the best option for you, a cardiac surgeon's office will contact you about your surgery date and preparation.
- Transcatheter Aortic Valve Replacement (TAVR)- This means that TAVR has been determined to be the best option for you. The team will recommend one of three ways to perform TAVR:
- Transfemoral TAVR - artery is accessed through the groin.
- Trans-subclavian TAVR - artery is accessed through the small opening on the left upper chest.
- Transcarotid TAVR - artery is accessed through the small opening on the left or right side of the neck.
Schedule a TAVR Assessment with The Heart Hospital at Saint Francis
For questions, or to determine if a transcatheter aortic valve replacement is right for you, please call the Valve Program at the Saint Francis Heart and Vascular Institute at 918-494-2464.