Is TAVR Right for You?

The aortic valve sits at the top of your heart. All the blood coming from your heart exits through this quarter-sized valve, which is about 2,000 gallons a day when your heart is healthy. Aortic valve stenosis is a condition that causes the valve opening to narrow and lose function. This requires your heart to work much harder than normal to keep oxygen-rich blood flowing to the rest of your body.

Cardiovascular surgeons have long been able to replace faulty heart valves with surgically implanted replacement valves. Unfortunately, many patients can’t have surgery or are unable to or don’t want to survive the rigors of an open-heart technique, which is the traditional method used to replace an aortic valve. Transcatheter aortic valve replacement (TAVR) is often the treatment of choice for not only these high risk patients but it is also approved for intermediate risk patients.

For many, TAVR has become a life-altering solution to the disability caused by significant aortic stenosis. Whether TAVR is the right treatment option for you depends on your symptoms and other overall health factors.

What happens during TAVR?

TAVR is a minimally invasive procedure that uses a catheter (hollow tube) to insert a manufactured aortic valve into the center of a dysfunctional, narrowed valve. It works much like the stents placed in arteries by gently enlarging the opening and restoring regulated blood flow through the aortic valve.

The catheter is typically fed through your femoral artery via a small puncture site in your groin. In some cases, Dr. Bokhari and his cosurgeons may use a small chest incision to access the femoral artery. With TAVR, however, you won’t need the large surgical incision required for open-heart surgery, and he won’t need to crack open your breastbone to access your heart.   

What are the benefits of TAVR?

Like any other procedure TAVR does carry some risks, however, it’s considered safer and has been proven to be 75% less risky than the open-heart surgery in large trials comparing the two options. Due to the less invasive technique, post-procedural pain with TAVR is typically much less and recovery is generally quicker with very little downtime than with traditional open heart surgery.

When is TAVR recommended?

We typically consider the severity of your symptoms and the valve narrowing when deciding if TAVR is the right option for you.

Because it generally takes many years to develop significant aortic stenosis, you may not notice problems for many years. Once symptoms develop, however, they can greatly impair your ability to perform even simple daily tasks. It can make a slow stroll to the mailbox feel like a marathon. At its worst, aortic stenosis may cause heart failure or sudden cardiac death.

Symptoms you or Dr. Bokhari may notice as aortic stenosis progresses include:

• Heart Murmur (abnormal heart sound)
• Dizziness or feeling faint and fainting with activity
• Chest pain or tightness with activity
• Shortness of breath with activities that did not bother you in the past
• Sensation of a rapid or fluttery heartbeat (palpitations)
• Significant fatigue that may occur with activity or even after a full night’s sleep
• Poor appetite and inability to gain weight
• Persistent swelling in the feet and ankles

TAVR is also an alternative for those patients who can’t have surgery or have underlying health conditions that greatly increase their risk of developing complications after surgery. TAVR has also now been approved for patients who are even at intermediate risk for open heart surgical replacement of the valve.

If you’re still wondering whether TAVR is right for you, please call Dr. Bokhari for an appointment soon.