Transcatheter Aortic Valve Replacement (TAVR)

Transcatheter Aortic Valve Replacement (TAVR) is a less invasive catheter-based aortic valve replacement procedure for patients at higher risk for traditional open heart surgical aortic valve replacement.

Yielding excellent results, the procedure is becoming increasingly more common [1-3].

During a TAVR procedure, a thin, flexible tube (catheter) is inserted in an artery, to guide the replacement heart valve up to the heart, replacing the diseased valve or failing surgical valve.  There are several different approaches that can be used, though in the majority of patients, delivery is through the groin.

In patients with small leg arteries a Trancaval approach (through the femoral vein) or Transcarotid/subclavian (through the carotid artery at the neck) approach is used, based on institutional and anatomical preferences.

The TAVR procedure requires a shorter hospital stay, generally three to five days. And recovery is much quicker than traditional surgery. Some patients have compared recovery to that following a balloon treatment or an angiogram.

*Indication for also lower risk patients is currently being studied in a multicenter trial. The results should be available in the next few years.

References

  1. Leon MB, Smith CR, Miller MM, et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med. 2010;363(17):1597-607.
  2. Smith CR, Leon MB, Mack MJ, et al. Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med. 2011;364(23):2187-98.
  3. Garg A, Rao SV, Visveswaran G, et al. Transcatheter aortic valve replacement versus surgical valve replacement in low-intermediate surgical risk patients: A systematic review and meta-analysis. J Invasive Cardol. 2017 Jun:29(6):209-216.