Transcatheter Aortic Valve Replacement (TAVR)

Basic Facts:

  • Transcatheter aortic valve replacement (TAVR) is a procedure for patients with severe and symptomatic aortic stenosis (narrowing of the aortic valve opening)
  • TAVR allows the aortic valve to be replaced without the need for open heart surgery. 

  • It is implanted through a cardiac catheterization, and a TEE is also performed during the procedure to help confirm device placement.

  • The valves used in TAVR are bioprosthetic, meaning they are made of animal tissue, typically from the sac of either a cow or pig’s heart. 

TAVR

TAVR is performed in a hospital by a doctor with specialty training in the procedure, along with a team including a cardiac surgeon and specialized cardiovascular nurses and technicians: 

  1. Under full/deep sedation, the doctor inserts a flexible tube (catheter) into a blood vessel in the groin area. The new valve is compressed and folded onto this catheter. 

  1. Using X-rays as a guide, the catheter is threaded up the blood vessels to the heart.  

  1. Once it is in place, the valve is opened within the existing valve, embedding inside the calcium of the old valve. The patient’s aortic valve is not removed in this procedure.  

  1. A TEE is performed during the procedure to help with guidance and to confirm valve placement. 

  1. The catheter is then withdrawn from the body, and the access site in the groin area is closed with a dissolvable collagen plug or small suture.  

  1. Typical length of stay is 24-48 hours; this is an inpatient/overnight procedure. 

The Virginia Heart Care Team will provide specific pre and post-procedure instructions, but general guidelines include: 

  • Stop eating and drinking the night before the procedure.  

  • Soreness around an access site is common afterwards, but it should not last more than one week. 

  • Patient will be discharged on a specific antiplatelet or anticoagulant plan, customized to each patient.  

  • Follow-up at one week to assess the wound and check-in on the patient. 

  • Follow-up echocardiogram and office visit with the Structural Heart Team is planned at 1 month and 1 year after TAVR. If all is well, the patient can then follow-up with their primary cardiologist and see the Structural Heart Team on an as-needed basis. 

  • Antibiotics prior to dental visits are REQUIRED for all patients who have had a valve replacement surgery.