Transcatheter aortic valve replacement (TAVR) procedure allows a team of physicians the ability to place a new valve within your diseased aortic valve. The team consists of specially trained cardiac surgeons, cardiologists and anesthesiologists. The new valve pushes the diseased valve leaflets aside and provides the framework to secure the new artificial valve in place. TAVR is less invasive than traditional surgery and is classified in three different ways based on the point of entry of the new valve: transfemoral, transapical and transaortic.
The femoral artery is accessed in the groin without an incision but with a needle, catheter and long wires allowing access to the diseased valve. This method is dependent on the patient anatomy and vessel size between the groin and heart. The delivery system is then placed over the long wires into the proper position and the new valve is deployed with a balloon and the aid of X-rays and an echocardiogram.
An incision is made in your chest between your ribs to access the apex (lowest portion) of your heart. A surgeon will place a sheath (a short hollow tube) that is slightly larger than a pencil through the apex into the left ventricle. The delivery system is then placed in the proper position and the new valve is deployed with a balloon and the aid of X-rays and an echocardiogram.
This approach requires cutting through a portion of your breastbone (partial sternotomy) or through a small incision between the ribs on the right side of your sternum (mini thoracotomy). A favorable puncture site is located on the greater curve, typically on the right lateral side of the aorta. The delivery system is then placed in the proper position and the new valve is deployed with a balloon and the aid of X-rays and an echocardiogram.
During your evaluation, the TAVR team will perform a number of assessments to determine if TAVR is an option for your condition. The three basic assessments are:
- Confirming Aortic Stenosis: Pre-operative Tests and Procedures
- Chest X-ray (CXR)
- Pulmonary function test (PFT)
- Cardiac catheterization (Angiogram)
- Transthoracic echocardiogram (TTE)
- Computerized tomography (CT Scan)
- Transesophageal echocardiogram (TEE)
- Magnetic resonance imaging (MRI)
- Risk Assessment
- Current medical status
- Medical history
- Your frailty
- Condition of your heart
- Best Treatment Options
This technique is for people who have been diagnosed with severe symptomatic aortic stenosis and are at intermediate to high risk for open heart surgery. The TAVR team will consider several factors to determine your level of risk and therefore candidacy for TAVR.
Five Major Factors
The TAVR team will review a patient’s records and test results to determine their candidacy based on their individual condition. Speaking with the surgeon and TAVR team will be best method to determine the best treatment options. CVT Surgical Center is committed to providing the best and safest options for the patient.