Transcatheter Aortic Valve Replacement

Transcatheter Aortic Valve Replacement

Transcatheter Aortic Valve Replacement (TAVR), also known as Transcatheter Aortic Valve Implantation (TAVI), is a minimally invasive surgical procedure used to replace a narrowed aortic valve that fails to open properly, a condition known as aortic stenosis. TAVR is an alternative to open-heart surgery and is particularly beneficial for patients who are considered high-risk for traditional surgical valve replacement.

Indications

TAVR is primarily indicated for patients with severe symptomatic aortic stenosis who are at intermediate or high risk for surgical aortic valve replacement. The decision to proceed with TAVR involves a multidisciplinary team approach, including cardiologists, cardiac surgeons, and other healthcare professionals.

Procedure

The TAVR procedure involves the insertion of a catheter through the femoral artery in the groin or through a small incision in the chest. The catheter is guided to the heart, where a replacement valve is deployed within the diseased aortic valve. The new valve is expanded, pushing the old valve leaflets out of the way and taking over the regulation of blood flow.

Types of Valves

There are several types of transcatheter valves used in TAVR, including:

• Balloon-expandable valves
• Self-expanding valves

Each type has specific indications and contraindications, and the choice of valve depends on the patient's anatomy and clinical condition.

Benefits

TAVR offers several benefits over traditional surgical valve replacement, including:

• Reduced recovery time
• Lower risk of complications
• Suitability for patients who are not candidates for open-heart surgery

Risks

As with any medical procedure, TAVR carries potential risks, including:

• Vascular complications
• Stroke
• Paravalvular leak
• Conduction disturbances requiring pacemaker implantation

Outcomes

Clinical trials and registries have demonstrated that TAVR is associated with improved survival and quality of life in patients with severe aortic stenosis. Long-term outcomes continue to be studied to better understand the durability of transcatheter valves.

Also see

• Aortic stenosis
• Heart valve disease
• Cardiac catheterization
• Minimally invasive surgery

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