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Transcatheter Aortic Valve Replacement (TAVR)

Transcatheter Aortic Valve Replacement (TAVR)

Transcatheter Aortic Valve Replacement in Kolkata

Innovation and advancement in the medical field pave the way for new treatment approaches, enhancing quality of life. The Transcatheter Aortic Valve Replacement (TAVR) procedure is one of them. It is an innovative and minimally invasive procedure, also called Transcatheter Aortic Valve Implantation (TAVI) used to replace the heart's aortic valve that narrows, restricting blood flow from the heart to the body. The condition in which the aortic valve blocks or restricts the blood flow is called aortic valve stenosis. As this procedure involves the insertion of a catheter through a small incision, it offers numerous benefits over traditional open-heart surgery.

Manipal Hospitals, Broadway has a team of highly skilled cardiologists and cardiac surgeons with the calibre to treat simple yet complex cardiac conditions with satisfaction. We offer world-class treatment using advanced procedures like Transcatheter Aortic Valve Replacement (TAVR), enhancing your quality of life. In this procedure, the new valve is deployed within the diseased valve, restoring normal blood flow. TAVR is generally safer and was developed as an alternative to surgery for high-risk patients who are not candidates for traditional surgery. As it offers better benefits it is increasingly being used for lower-risk patients as well. TAVR represents a significant advancement in the treatment of aortic valve stenosis, offering a viable alternative to open-heart surgery for many patients. 

 

FAQ's

TAVR is mostly beneficial for patients suffering from severe aortic stenosis, as it offers a minimally invasive option to traditional open heart valve surgery. The doctor recommends this procedure if you have:

  • Aortic stenosis with a high-risk condition who cannot tolerate open surgical procedure
  • Severe symptoms such as shortness of breath, chest pain, swelling of the leg, fatigue, etc along with aortic stenosis
  • Implanted biological tissue valve that fails to work
  • Intermediate-risk patients who are inoperable and cannot tolerate open-heart surgery
  • Patients with other health conditions, such as lung or kidney disease impose a higher risk of complications with open heart surgery
  • Previous heart surgery
  • Weaker heart 
  • History of stroke

Before the TAVR procedure, the doctor may ask you to undergo the following diagnostic tests to decide the right treatment approach:

  • Blood tests
  • Echocardiogram - Transthoracic and Transesophageal
  • Electrocardiogram
  • Computed Tomography
  • Left heart catheterization
     
  • Before the surgery, you will need to undergo certain tests to evaluate your overall health.
  • Inform the healthcare team about all the medications you are taking and any drug allergies, you may have.
  • Ask the provider which medicines you are allowed to take before the surgery.
  • You will need to quit smoking if you still smoke.
  • You will be informed not to drink or eat anything before the procedure, as instructed.
  • Arrange and pack the clothing and personal items that will be needed in the hospital.
  • You will not be allowed to wear contact lenses, jewellery, nail polish, eyeglasses, and dentures during the procedure.
     
  • Before the procedure begins, you will need to change into a hospital gown.
  • You will be asked to empty the bladder.
  • A healthcare professional will insert an IV into your forearm or hand.
  • A sedative will be administered through this IV to induce feelings of relaxation, calmness, or drowsiness.
  • Additional medications to prevent blood clots and infection may also be administered through the IV.
  • The healthcare professional may shave any hair from the area of your body where the procedure will be performed.
  • You will need to lie on your back for the procedure. 
  • The skin over the surgical site will be cleansed with an antiseptic solution.
  • During the procedure, your damaged aortic valve will be replaced with a biological tissue valve.
  • It involves small surgical incisions and a flexible catheter to reach the heart.
  • The procedure begins with a doctor inserting a catheter into a blood vessel, typically in the groin or chest area, guided by X-ray or other imaging tools to reach the heart's aortic valve.
  • Then the biologic tissue valve will be delivered through the catheter to the location of the aortic valve. 
  • A balloon on the catheter tip may be inflated to press the new valve into place, although some replacement valves may expand without a balloon.
  • Once the new valve is securely positioned, the doctor removes the catheter.
  • Throughout the TAVR procedure, the healthcare team will closely monitor vital signs such as blood pressure, heart rate, rhythm, and breathing.
     
  • After the TAVR procedure, you may be admitted to the hospital's intensive care unit (ICU) for close monitoring overnight.
  • The duration of hospital stays post-TAVR varies depending on individual factors. Some patients may be discharged as early as the next day.
  • Before discharge, our treatment team will provide instructions on wound care and how to monitor for signs of infection.
  • Signs of infection to watch for include fever, increased pain, redness, swelling, dizziness, sudden weight gain, extreme tiredness, or drainage at the catheter site.
  • After TAVR, several medications may be prescribed, such as blood thinners and antibiotics.
  • You will be asked to come for regular checkups and undergo imaging tests to ensure that the new valve is working properly. 

TAVR has become the most common method for aortic valve replacement by offering various benefits, such as:

  • Safe and effective
  • Less invasive
  • Easier recovery
  • Shorter hospital stays
  • Better treatment outcomes
  • Improves chances of survival
  • Fewer chances of complications
  • Less chances of infection
     

The durability of the TAVR valve will depend on factors such as the patient's age, medical status, and the specific type of prosthetic valve employed. Typically, younger patients are offered mechanical valves, which have the potential to stay during the patient's lifetime but will require lifelong use of anticoagulants. In contrast, biological prosthetic valves are prone to structural valve deterioration and may last for approximately 5–10 years with adequate follow-up care. Valves in younger patients, who tend to be more active, have been observed to last around 5 years on average.
 

Although TAVR is generally a safe and effective procedure, but carries certain risks too, such as: 

  • Leaky valves
  • Myocardial infarction
  • Cerebrovascular complications
  • Vascular access-site complications
  • Coronary obstruction
  • Kidney disease
  • Problems with replacement valve
  • Heart attack
  • Death
  • Stroke
  • Low blood pressure
  • Reaction to anaesthesia
  • Bleeding

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