TAVR Is A New Lease of Life

TAVR Is A New Lease of Life

Transcatheter Aortic Valve Replacement (TAVR) is a suture-less knife-less minimally invasive procedure to replace a narrowed aortic valve that fails to open properly (Aortic Valve Stenosis). TAVR is sometimes called Transcatheter Aortic Valve Implantation (TAVI). TAVR, just like open heart surgery, can relieve the signs and symptoms of aortic valve stenosis and improve survival without adding significant surgical risk.



TAVR is indicated for people who have severe aortic stenosis needing valve replacement but are placed at higher risk of complications from Surgical Aortic Valve Replacement. The decision to treat aortic stenosis with open heart surgery or TAVR is made after consultation with a multidisciplinary group of medical and surgical heart specialists who, in discussion with the patient and family, individualize the best treatment option for that particular patient. Dr.Anoop Agrawal, Sr.Consultant Cardiologist, CARE Hospitals Banjara Hills, talks about the need and benefits of this surgery.



Aortic Valve Stenosis or Aortic Stenosis occurs when the heart's aortic valve narrows. This narrowing prevents the valve from opening fully, which obstructs blood flow from the heart into the aorta and onward to the rest of the body. Aortic Stenosis can cause chest pain, fainting, fatigue, leg swelling and/or shortness of breath. It may also lead to heart failure and sudden cardiac death.


Medications have no role in the treatment of Aortic Stenosis. The only treatment is to implant a new artificial in place of the narrowed aortic valve. Traditionally it is done via open heart surgery where the patient is anesthetized and put on a heart-lung bypass machine. The Heart Surgeon opens the chest and implants a new valve in place of the old one. Patients typically spend 2-3 days in the ICU and another 3-5 days in the general ward. Many patients are considered to be at higher risk for open heart surgery or don’t want to undergo surgery due to age, other diseases, etc. There was no viable alternative to surgery for such patients, until now. TAVR is an excellent option for such patients. TAVR allows implanting a new valve without the need for surgery.




Benefits of TAVR:


•          TAVR may be an option for patients who have Severe Aortic Stenosis that is causing stress to the heart and who shouldn’t or couldn’t undergo open heart surgery for valve replacement. People for whom surgery is typically less desirable are those who are elderly, have multiple medical problems, had open heart surgery before, etc. Medical conditions that increase the risk of Surgical Aortic Valve Replacement include diseases involving lung, kidneys, liver, brain, breast cancer, etc.


•          TAVR may also be an option in patients who have an existing biological tissue valve that was previously implanted via open heart surgery to replace the aortic valve but is not functioning well anymore. Before TAVR, patients are evaluated by a multidisciplinary team of heart valve specialists to determine the best treatment option.


•          TAVR relieves signs and symptoms of Aortic Stenosis, adds years of productive life, and improves overall health. Scientific studies have found TAVR to be highly effective, similar or better than open heart surgery in people with Aortic Stenosis irrespective of their surgical risk profile.



Patients typically don’t need to be on blood thinners after TAVR, although they may need to continue taking certain heart medications after the procedure. Regular routine follow-up with a Cardiologist is necessary to ensure things are going in the right order. A routine Echocardiogram is done periodically to ensure the heart and the valve is working fine. While TAVR gets its work done, there is no replacement for healthy lifestyle changes, such as eating a heart-healthy diet, exercising regularly, maintaining a healthy weight and avoiding smoking.



TAVR can easily be regarded as the most disruptive innovation in cardiovascular medicine in the past decade. As it stands today, TAVR is a life-saving treatment alternative for many patients with severe AS who till now had no option other than to undergo open heart surgery. TAVR offers similar benefits of implanting a new valve as in open heart surgery, minus the surgical risk.