TAVR Transcatheter Aortic Valve Replacement is a minimally invasive procedure for treating Aortic Stenosis, a progressive and life-threatening disease. Without treatment, 50 percent of all patients will die within two years.
Berks Cardiology is the first practice in the region to offer TAVR. The procedure is administered at Penn State Health St. Joseph Medical Center. Doctors use The Edwards Sapien transcatheter heart valve, which may be delivered through several different approaches, including: Transfemoral, Transapical, and Transaortic.
What is a TAVR? (Also called TAVI)
This minimally invasive surgical procedure repairs the valve without removing the old, damaged valve. Instead, it wedges a replacement valve into the aortic valve’s place. The surgery may be called a transcatheter aortic valve replacement (TAVR) or transcatheter aortic valve implantation (TAVI).
Valve-within-valve — How does it work?
Somewhat similar to a stent placed in an artery, the TAVI approach delivers a fully collapsible replacement valve to the valve site through a catheter.
Once the new valve is expanded, it pushes the old valve leaflets out of the way and the tissue in the replacement valve takes over the job of regulating blood flow. This procedure is fairly new and is FDA approved for people with symptomatic aortic stenosis who are considered a high risk patient for standard valve replacement surgery. The differences in the two procedures are significant.
What is involved in a TAVR procedure?
Usually valve replacement requires an open heart procedure with a sternotomy. The chest is surgically separated (open) for the procedure. The TAVR or TAVI procedures can be done through very small openings that leave all the chest bones in place.
TAVR is not without risks, but it’s the best option for some patients and promises a faster recovery time in most cases. Patient down-time and recovery with TAVR may be comparable to balloon treatment or angiogram and will likely reduce a hospital stay to an average of 3-5 days.
The procedure has two approaches, letting the surgeon choose the best and safest way to access the valve: entering through the vein in the groin (transfemoral) or between two ribs (transapical).
Who is a good candidate for TAVR?
TAVR is currently reserved for patients with a high-risk factor for open heart surgery due to age or other existing medical conditions. Most patients are more than 70 years of age. Though relatively new, TAVI can be an effective option to improve quality of life in patients who otherwise have limited choices for repair of their aortic valve.
Is there any type of financial assistance for people in need of TAVR?
TAVR is approved and available for qualifying patients receiving Medicare and Medicaid. Get more information at: Centers for Medicare & Medicaid Services. For guidance on healthcare laws and government programs designed to provide affordable coverage, visit: HealthCare.gov.
Attend our live presentations
Dr. Guy Piegari, an interventional cardiologist, periodically gives talks on TAVR at the St. Joseph Medical Center Bern campus. Get more information now.
(1) Otto CM. Timing of aortic valve surgery. Heart. 2000;84:211-21.
Original Article: American Heart Association