TRANSCATHETER AORTIC VALVE REPLACEMENT (TAVR)
Interventions
What is transcatheter aortic valve replacement?
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Transcatheter aortic valve replacement (TAVR) is a medical procedure in which the aortic heart valve is replaced with a mechanical or bioprosthetic valve. TAVR differs from open surgery valve replacement techniques in that the replacement valve is delivered with a catheter through the blood vessels. Modern TAVR devices consist of a stent component, which forces open the damaged valve and keeps the device in position, and a valve component that regulates flow like a natural heart valve.¹
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What conditions are treated with transcatheter aortic valve replacement?
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Transcatheter aortic valve replacement (TAVR) is used to treat individuals with severe aortic valve stenosis. TAVR is an effective alternative to surgical aortic valve replacement (SAVR) for individuals that are not healthy enough to undergo a major heart surgery.²
More recent studies have shown that ‘valve-in-valve TAVR’ can also help improve heart function in patients that have previously received a bioprosthetic valve implant and are now dealing with bioprosthetic stenosis.² There are also a number of experimental indications for transcatheter valve replacement that have been reported, including use in bicuspid aortic valves as well as mitral, tricuspid, and pulmonary valve positions.³
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How is a transcatheter aortic valve replacement performed?
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Transcatheter aortic valve replacement, also called transfemoral aortic valve replacement, begins with a single ‘keyhole’ puncture in the groin. A small tube called a catheter is inserted into the puncture and navigated up the aorta. through the aortic valve, and into the left aorta. The catheter is replaced with a guidewire, which allows your interventional cardiologist to guide the valve replacement device to the aortic valve. The replacement valve is deployed within the diseased aortic valve, where it immediately begins to function as a healthy aortic valve would.
References
[1] Cribier, A. (2017). The development of transcatheter aortic valve replacement (TAVR). Global Cardiology Science and Practice, 2016(4), 160–164.
[2] Nishimura, R. A., O’Gara, P. T., & Bonow, R. O. (2017). Guidelines Update on Indications for Transcatheter Aortic Valve Replacement. JAMA Cardiology, 2(9), 1036.
[3] Praz, F., Windecker, S., Huber, C., Carrel, T., & Wenaweser, P. (2015). Expanding Indications of Transcatheter Heart Valve Interventions. JACC: Cardiovascular Interventions, 8(14), 1777–1796.
