TAVR / TAVI - Transcatheter Aortic Valve Replacement
TAVR or TAVI stands for transcatheter aortic valve replacement. It is an exciting technology that allows physicians to fix a severely narrowed aortic valve (aortic stenosis) without opening up the patient's chest.
What is aortic stenosis?
Aortic stenosis is a condition that results from narrowing of the aortic valve of the heart. This valve normally allows blood flow to be pumped from the main chamber of your heart to the rest of your body. When this valve becomes significantly narrowed, it can put an increased amount of stress and pressure on the heart muscle. This can lead to symptoms of chest discomfort, shortness of breath, leg swelling, fatigue, lightheadedness, syncope (passing out spells), and even sudden death.
What are the causes of aortic stenosis? Is it common?
The most common cause of aortic stenosis is degenerative (age-related calcium deposits). Other causes include congenital disorders (bicuspid aortic valve), infection on the heart valve, or rheumatic fever. It is estimated that over 1.5 million people have aortic stenosis in the United States and over 500,000 patients have severe aortic stenosis.
What is the natural history of aortic stenosis?
If left untreated, the prognosis of patients who have symptoms from their severe aortic stenosis is poor. In general, 50% of patients will not be alive after 2 years from the onset of their symptoms.
How is aortic stenosis diagnosed?
People with aortic stenosis may have a "murmur" that can be detected during a regular doctor's visit and general physical examination. This may alert the physician to order an ultrasound (echocardiogram) of the heart. This ultrasound test most often provides images and information to confirm the presence of aortic stenosis.
What is the treatment for aortic stenosis?
The treatment for aortic stenosis is dependent on the severity of the aortic stenosis, the symptoms being caused by the aortic stenosis, and the overall health of the patient. Most commonly, the treatment for people with severe aortic stenosis with symptoms is standard valve replacement surgery.
What is TAVI or TAVR?
TAVI or TAVR stands for transcatheter aortic valve replacement. Currently, this is an option for patients with severe aortic stenosis causing symptoms that are too high risk for standard valve replacement surgery.
During a TAVI or TAVR procedure, a catheter about the size of a pen, is inserted in the artery in the leg and carefully passed up into the heart. One type of TAVR valve, made of bovine (cow) tissue and supported on a metal stent, is then implanted inside the narrowed valve resulting in a normal functioning aortic valve. With a TAVR procedure, the patient does not need the chest opened for surgery or put on a heart-lung (bypass) machine.
Is TAVI/TAVR safe?
The TAVI/TAVR procedure has been done in over 50,000 patients worldwide. It was FDA approved in November 2011. In the research trials evaluating TAVI/TAVR, it was shown to significantly allow patients to live longer and with better quality of life when compared to treating with medicines only. As with any heart procedure, TAVI/TAVR has its own risks. These risks can be discussed with your physician at the time of your appointment.
Where is TAVI/TAVR being done? Who does this procedure?
Currently, the FDA is allowing TAVI/TAVR to be done at hospitals with a high level of cardiac and heart surgery experience. The procedure is performed by a team of physicians including both cardiologists and heart surgeons. At this time, Dr. Ravi Ramana of Heart Care Centers, is performing this procedure at Advocate Christ Medical Center.
What's the next step?
If you feel that you or a loved one may have aortic stenosis and may benefit from a TAVR procedure, please feel free to contact us to schedule an appointment with Dr. Ramana (1-708-274-3278). We will be happy to answer any questions you may have at that time.