Transcatheter Aortic Valve Replacement

Advanced treatment for patients with aortic stenosis 

Carondelet Health Network is proud to offer the Transcatheter Aortic Valve Replacement (TAVR) program to residents in Tucson and Southern Arizona. Our TAVR surgery team is composed of a multidisciplinary, collaborative group of physicians and caregivers, including interventional cardiologists, cardiothoracic surgeons, imaging professionals, anesthesiologists, advanced care nurses and valve clinic coordinators. 

Our cohesive approach embodies optimal patient-centric care and collaborative therapy decisions. If you have aortic stenosis, your physician will conduct a comprehensive evaluation to determine whether the TAVR procedure is appropriate and recommend a treatment plan. 

What is aortic stenosis? 

Aortic stenosis (AS) is one of the most common and serious valve diseases. With AS, the opening of the aortic heart valve narrows. As a result, the heart needs to work harder and may not pump enough oxygen-rich blood to the body. Aortic stenosis can be caused by a birth defect, rheumatic fever, radiation therapy or can be related to age. 

Approximately 2.5 million people in the United States over the age of 75 suffer from this condition.  In elderly individuals, aortic stenosis is sometimes caused by the buildup of calcium (mineral deposits) on the aortic valve’s leaflets. Over time, the leaflets become stiff, which reduces their ability to fully open and close. When the leaflets don’t fully open, a person’s heart must work harder to push blood through the aortic valve to the rest of the body. As a result, less oxygen-rich blood flows from the lungs to the brain and the rest of the body, which may cause symptoms. 

Risks for aortic valve disease:

  • Aging 
  • High blood pressure 
  • High cholesterol 
  • Smoking

What are the symptoms of aortic stenosis? 

Symptoms may be misunderstood as a common sign of aging: 

  • Fainting 
  • Breathlessness 
  • Chest pain, pressure or tightness 
  • A decline in activity level or reduced ability to do routine physical tasks

Individuals may live with aortic stenosis for many years during a latent, asymptomatic period, even before the condition's symptoms develop. If experiencing these symptoms, please see a physician for a proper diagnosis. 

Severe symptomatic AS can be life-threatening without treatment.

Individuals with severe AS may have a survival rate as low as 50% at two years and 20% at five years without getting treatment after symptoms appear. Traditional treatment for this condition is open-heart surgery, which can lead to extensive hospital stays and recovery times. 

Transcatheter aortic valve replacement may be a safer option for patients with severe AS for whom open heart surgery is too high a risk.

Frequently asked questions about TAVR 

You may stay in the hospital for a few days, and it may just take a few weeks for you to resume daily activities (e.g., exercising, driving, etc.). After the procedure, individuals will be given medications to prevent infection or abnormal clots. Your doctor will want to see you for follow-up visits to check on the healing process and valve performance. 

TAVR cardiac operation is usually performed in the hospital. Before surgery, you will receive anesthesia and a medication to prevent severe blood clots. 

The valve and delivery systems should not be performed in individuals who cannot tolerate medications that thin the blood or prevent blood clots, or have an active infection in the heart or elsewhere. 

TAVR surgery can be performed in individuals across all risk categories. However, this is not the only factor to consider. TAVR may not be the right procedure for everyone. Our experienced team at Carondelet will assess and review all your relevant information and provide a treatment plan for you. 

The length of your tissue valve depends on many patient factors and medical conditions. Regular follow-ups will help your physicians know how your valve is working. 

A TAVR procedure may help your heart work better, extending the quality and length of life if you have serious aortic stenosis. It may also reduce your recovery time to get back to everyday tasks. Quality of life studies have shown improvements in patient health within 30 days, including the ability to take care of themselves and participate in routine tasks. 

Patients will be evaluated for risks such as operative mortality, patient frailty, significant organ system compromise, other major comorbidities and procedure-specific impediments. Like most surgeries, though there is a low chance of having one, there are risks when a patient undergoes a TAVR process, such as heart attack, stroke, bleeding, need for emergency operation and potential damage to the electrical system of the heart.

Transcatheter aortic valve replacement is a less invasive, catheter-based technique for replacing the diseased aortic valve. An interventional cardiologist and a cardiothoracic surgeon will work together in the TAVR process. They will guide a new valve into the heart through an incision in the leg , using guidance from X-ray and echocardiography. 

Multiple access approaches can be used to perform the TAVR process. However, the most frequent approach is the transfemoral approach, in which the valve is delivered via a catheter through the femoral artery. A less intrusive approach uses a small incision in the chest to enter the tip of the left ventricle; this is also called the transapical approach.

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