Transcatheter Aortic Valve Replacement (TAVR)

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The heart plays a vital role in circulating oxygen-rich blood throughout the body. At the center of this process are the heart valves, which open and close with each heartbeat to keep blood moving in the right direction. However, when a heart valve is not functioning properly, it can disrupt circulation and put extra strain on the heart.

The aortic valve is one of four valves that control blood flow in the heart. It specifically controls blood flow from the heart’s left ventricle into the aorta. Aortic valve stenosis occurs when the aortic valve becomes narrowed or stiff, resisting blood flow and causing chest pain and shortness of breath. Transcatheter aortic valve replacement (TAVR) can make a difference by restoring blood flow, improving heart function and helping patients return to a more active and healthy lifestyle.

What Is a TAVR Procedure?

In TAVR surgery, also known as transcatheter aortic valve implantation (TAVI), a doctor inserts a thin, flexible tube called a catheter into a blood vessel, usually through the groin, thigh, stomach area, chest, neck or collarbone. The catheter carries a folded replacement valve, which is carefully guided to the heart and placed inside the old aortic valve. Once in position, the new valve expands to take over the job of regulating blood flow.

Is TAVR a Major Surgery?

TAVR surgery is a minimally invasive heart valve replacement that requires only a small incision in the skin, unlike open-heart surgery. However, like any medical procedure, TAVR surgery does carry some risks. In rare cases, the replacement valve can push aside the old valve's flaps, blocking blood flow to the heart. This condition, called coronary artery obstruction, is a serious but rare complication. Your doctor will carefully assess your heart health to determine if TAVR surgery is right for you.

How Is a TAVR Performed?

The minimally invasive heart valve replacement TAVR surgery can be performed using different approaches, depending on a patient’s health and the condition of their blood vessels. The most common method involves accessing the heart through the femoral artery, a major blood vessel in the groin or thigh. During the TAVR surgery, the doctor guides a thin, flexible tube with a folded replacement valve through the artery and into the heart. Once in position, the new valve expands to take over the function of the diseased aortic valve.

If the femoral artery is too small or damaged, alternative access points may be used, including:

Transapical access – The doctor guides the catheter through blood vessels in the chest.
Transcaval access – This approach uses blood vessels in the stomach area. A doctor creates small openings in the vena cava and aorta to route the catheter to the heart. This method can benefit high-risk patients, including women with smaller arteries.
Transcarotid access – When other access points are unsuitable, the catheter is inserted through the carotid artery in the neck.
The heart is reached through a vessel under the clavicle (collarbone), often used in patients with previous heart surgery.
Transseptal access – In rare cases, the doctor guides the catheter through the septum, the wall separating the heart’s right and left atria.

These minimally invasive techniques help expand access to TAVR for aortic stenosis, allowing more patients with aortic valve stenosis to undergo treatment for aortic valve disease without open-heart surgery.

What Are TAVR Valves Made Of?

TAVR valves are tissue valves, also known as biological or bioprosthetic valves. They are typically made from pig or cow tissue and specially treated to prevent rejection by the body. Human tissue is called a homograft valve and may sometimes be used.

Unlike mechanical valves, which are made from carbon and metal and require lifelong blood-thinning medication to prevent clots, tissue valves do not typically require long-term anticoagulant therapy. However, they may wear out over time and could need to be replaced or repaired after 10 to 20 years.

How Long Does the TAVR Procedure Take?

A TAVR surgery typically takes one to two hours, though it may take longer in some cases. Cardiologists specializing in heart care perform this minimally invasive heart valve replacement in a hospital.

Before starting, your healthcare team will measure the valve opening and give you medications to help you relax or sleep and medicines to prevent blood clots. In most cases, you will remain awake during the procedure with sedation and local anesthesia to keep you comfortable.

Find a Cardiologist in San Antonio

HealthCare is Better Together.

When it comes to cardiac care, we understand that heart and vascular issues require experienced medical intervention and compassion. Our multidisciplinary approach at North Central Baptist Hospital includes coordinating cardiologists, surgeons and other healthcare professionals who are dedicated to helping ensure comprehensive care and optimal cardiac health outcomes.

Whether you need emergency cardiac care, a vascular procedure or ongoing preventive care, our cardiac and vascular services can help. Let us help you stay on top of your heart health with the multidisciplinary cardiovascular care available at North Central Baptist Hospital. Call us at 210-297-4000 or learn more about our comprehensive cardiovascular services here.