Transcatheter Aortic Valve Replacement (TAVR)

Transcatheter aortic valve replacement (TAVR) is a minimally invasive alternative to open heart surgery for people with a life-threatening condition called aortic stenosis in which the aortic becomes too stiff or narrowed. This causes the heart to work harder to push blood throughout the body, which may lead to heart failure.

Replacing the aortic valve traditionally required opening the chest surgically. With TAVR, the replacement valve is implanted with a small catheter inserted through very small openings in either the femoral artery or the chest.

The UCI Health Cardiovascular Center has a highly skilled team of structural heart disease specialists with expertise in the TAVR procedure. Team members, who work in coordination to deliver the best, most compassionate patient care, include:

To learn more about TAVR or schedule an evaluation, call 714-380-7735 or request an appointment online.

What is aortic stenosis?

Each valve in your heart has two or three flaps of tissue, which open and close like gates to regulate the flow of blood through the heart in one direction.

Symptoms and causes

When less oxygen-rich blood is making its way to your brain and lungs, it leads to symptoms such as:

• Chest pain or tightness
• Heart palpitations
• Fatigue
• Shortness of breath
• Lightheadedness, feeling dizzy or fainting (syncope, a sudden loss of consciousness)
• Difficulty when exercising
• Difficulty walking short distances

Aortic stenosis has several possible causes, including:

• Birth defect
• Rheumatic fever
• Radiation therapy
• Age

Diagnosis

Diagnosis of aortic stenosis begins with an evaluation by your cardiologist, who will take your history and perform a physical exam. 

Your cardiologist will then use noninvasive tests to make a diagnosis. Tests may include:

• Transthoracic echocardiogram
• Transesophageal echocardiogram
• Cardiac catheterization
• Stress test
• CT scan

Treatments

Treating severe aortic stenosis is critical: Approximately 50% of people who develop the condition will die within two years without treatment.

Treatment typically involves either:

• Open-heart surgery, which requires the use of a heart-lung machine to take over your heart function. During this procedure, the diseased valve is removed and a new valve is inserted.
• Transcatheter aortic valve replacement (TAVR), which is a catheter-based technique to implant a new valve without open-heart surgery. During this procedure, an interventional cardiologist guides a new valve into the heart through an incision in the leg or chest.

Not everyone is a candidate for TAVR. Multiple factors specific to you will be used to determine which approach would be best, including the risk of the operation, your overall condition and any other conditions (comorbidities) you may have. TAVR should not be used if you cannot tolerate blood-thinning medications or if you have an active infection in the heart. 

TAVR benefits

The benefits of TAVR include:

• Less invasive approach without opening the chest wall or heart
• Better heart function
• Shorter recovery time
• Faster return to daily activities
• More independence

Insertion procedure

This video demonstrates how TAVR is inserted into your valve:

There are two approaches to TAVR insertion, which may be performed under conscious sedation:

• Transfemoral approach — An incision on your upper leg is made to give the surgeon access to your femoral artery.
• Transapical approach — An incision is made on the chest between the ribs to access the lowest part of your heart, called the apex. 

Your heart team will evaluate you and recommend which approach would best suit you.

After insertion, you will be hospitalized for about two to three days.

After the procedure

Your UCI Health heart team, which includes a cardiologist, cardiothoracic surgeon, TAVR coordinator and echocardiographer, will discuss and guide your plan of care throughout all stages of the TAVR. They will provide specific instructions to help you with your recovery. 

After the procedure, you will stay in the hospital for a few days. During this time, your care team will manage your pain and assist you with sitting up, walking and breathing.

After you are discharged, regular checkups with your physician are important to ensure that your TAVR is functioning properly. If you have any problems such as bleeding, pain, discomfort or other changes in your health, call your doctor as soon as possible.

Always tell your other doctors about your heart valve replacement before any medical, dental or MRI procedures. Failure to do this can result in injury or death.

To contact the TAVR team, please call 714-380-7735 or request an appointment online.