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Minimally invasive aortic valve replacement (TAVR)

Transcatheter Aortic Valve Replacement, also known as TAVR, is a less-invasive, catheter-based technique to replace a failing aortic valve in patients with severe aortic stenosis. Prior to the introduction of TAVR, the only treatment for this condition was open-heart surgery.

What is aortic stenosis?

Aortic stenosis is a condition in which the aortic valve, the main valve between the heart and the rest of the body, becomes stiff due to the buildup of plaque on the valve leaflets. This buildup prevents the valve from opening and closing properly, allowing blood to flow backward into the heart. This make it difficult for the heart to pump blood to the rest of the body.

Symptoms of aortic valve disease include increased fatigue, decreased activity tolerance, chest discomfort, difficulty breathing, lightheadedness, dizziness and fainting. Aortic valve disease can occur for any number of reasons, but the most common cause in the U.S. is age.

Treating aortic stenosis

The treatment for advanced aortic valve disease is valve replacement. Traditionally, this has performed through a surgical procedure in which the cardiothoracic surgeon makes an incision across the chest to access the heart. During an open-heart procedure, the patient is put on a heart-lung machine, the diseased valve replaced, and a new valve (biological or mechanical) is sewn into place.

Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure similar to a cardiac catheterization. After the patient receives anesthesia, a balloon catheter is guided through the femoral (leg) artery to aorta and on to the aortic valve. Once in place, the physician deploys a balloon, destroying the plaque buildup and restoring the size of the aortic valve opening. The balloon is removed and a catheter carrying the new valve is guided through the arteries to the aortic valve. Once in place, the valve is deployed and begins working immediately.

Because TAVR is minimally invasive, patients enjoy a shorter hospital stay, less discomfort, and a faster return to normal daily activities. Initially available only to patients considered to be too high risk for open-heart surgery, today TAVR is available to all patients with severe aortic stenosis. The animation, below, shows the TAVR procedure.

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