TAVR is an acronym for Transcatheter Aortic Valve Replacement. TAVR is a minimally invasive procedure used to treat Aortic Stenosis, a progressive and life-threatening disease. Without treatment, 50% of all patients will die within two years. (1)
Berks Cardiologists, Ltd. is the first practice in the region to offer TAVR at the St. Joseph Medical Center Regional Health Network. Doctors use The Edwards Sapien transcatheter heart valve, which may be delivered through several different approaches, including: Transfemoral, Transapical, and Transaortic.
What is a TAVR? (Also called TAVI)
This minimally invasive surgical procedure repairs the valve without removing the old, damaged valve. Instead, it wedges a replacement valve into the aortic valve’s place. The surgery may be called a transcatheter aortic valve replacement (TAVR) or transcatheter aortic valve implantation (TAVI).
Valve-within-valve — How does it work?
Somewhat similar to a stent placed in an artery, the TAVI approach delivers a fully collapsible replacement valve to the valve site through a catheter.
Once the new valve is expanded, it pushes the old valve leaflets out of the way and the tissue in the replacement valve takes over the job of regulating blood flow. This procedure is fairly new and is FDA approved for people with symptomatic aortic stenosis who are considered a high risk patient for standard valve replacement surgery. The differences in the two procedures are significant.
What is involved in a TAVR procedure?
Usually valve replacement requires an open heart procedure with a “sternotomy.”, in which the chest is surgically separated (open) for the procedure. The TAVR or TAVI procedures can be done through very small openings that leave all the chest bones in place.
A TAVR procedure is not without risks, but it provides beneficial treatment options to people who may not have been candidates for them a few years ago while also providing the added bonus of a faster recovery in most cases. A patient’s experience with a TAVR procedure may be comparable to a balloon treatment or even an angiogram in terms of down time and recovery, and will likely require a shorter hospital stay (average 3-5 days).
The TAVR procedure can be performed using one of two different approaches, allowing the surgeon to choose which one provides the best and safest way to access the valve: Entering through the vein in the groin (called a transfemoral approach) or Entering from between two ribs (called a transapical approach.)
Who is a good candidate for this type of valve surgery?
At this time the procedure is reserved for those people for whom an open heart procedure is too risky. For that reason, most people who have this procedure are in their 70s or 80 and often have other medical conditions that make them a better candidate for this type of surgery.
Although relatively new, TAVI can be an effective option to improve quality of life in patients who otherwise have limited choices for repair of their aortic valve.
Is there any type of financial assistance for people in need of TAVR or TAVI valve replacement who lack necessary funds or healthcare coverage for the procedure?
TAVR is approved and available for qualifying patients receiving Medicare and Medicaid. More information is available on the Centers for Medicare & Medicaid Services (CMS) website. Learn more about healthcare laws and government programs seeking to provide affordable coverage at the HealthCare.gov website.
(1) Otto CM. Timing of aortic valve surgery. Heart. 2000;84:211-21.
Original Article: American Heart Association