Percutaneous aortic valve replacement

1. Percutaneous Aortic Valve Replacement

Percutaneous aortic valve replacement (PAVR), also known as transcatheter aortic valve replacement (TAVR), is a minimally invasive procedure used to replace a diseased aortic valve in the heart. This procedure is typically recommended for patients with severe aortic stenosis who are considered high-risk candidates for traditional open-heart surgery.

Indications

PAVR is primarily indicated for patients with symptomatic severe aortic stenosis who are at high or prohibitive risk for surgical aortic valve replacement (SAVR). It is also considered for patients with intermediate risk, depending on their overall health status and the presence of comorbidities.

Procedure

The procedure involves the insertion of a catheter through the femoral artery or, in some cases, through a small incision in the chest. The catheter is guided to the heart, where a new valve is deployed to replace the malfunctioning aortic valve. The new valve is typically made of biological tissue and is mounted on a metal stent.

Steps

1. **Access**: The procedure begins with gaining access to the femoral artery or another suitable entry point. 2. **Valve Deployment**: The catheter carrying the new valve is advanced to the heart. The new valve is positioned within the diseased aortic valve and expanded, pushing the old valve leaflets aside. 3. **Verification**: Imaging techniques such as echocardiography and angiography are used to verify the correct placement and function of the new valve.

Benefits

- **Minimally Invasive**: PAVR is less invasive than traditional surgery, resulting in shorter recovery times and reduced hospital stays. - **Suitable for High-Risk Patients**: It offers an option for patients who are not candidates for open-heart surgery due to age or other health issues.

Risks

While PAVR is generally safe, it carries risks such as: - Stroke - Vascular complications - Bleeding - Heart block requiring a pacemaker

Recovery

Patients typically experience a shorter recovery period compared to those undergoing surgical valve replacement. Most patients are able to return to normal activities within a few weeks.

See Also

- Aortic stenosis - Heart valve replacement - Cardiology

References

• Smith, C. R., et al. (2011). "Transcatheter versus Surgical Aortic-Valve Replacement in High-Risk Patients." *New England Journal of Medicine*.
• Leon, M. B., et al. (2010). "Transcatheter Aortic-Valve Implantation for Aortic Stenosis in Patients Who Cannot Undergo Surgery." *New England Journal of Medicine*.

External Links

• [American Heart Association - TAVR](https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/heart-valve-surgery/transcatheter-aortic-valve-replacement-tavr)

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