Transcatheter aortic valve replacement (TAVR), also called transcatheter aortic valve implantation (TAVI), is a minimally invasive procedure to replace a diseased aortic valve. It is used to treat severe aortic stenosis, a type of valve disease in which the aortic valve becomes narrowed over time, reducing blood flow from the heart into the aorta.
Aortic valve stenosis is progressive and can quickly become life-threatening. Without treatment, just two years after the first symptoms appear, the survival rate is as low as 50%.
Interventional cardiologists at Rush have been leaders in bringing this innovative treatment to patients, and in clinical trials of the valves used for TAVR, such as the Edwards SAPIEN valve and the Medtronic CoreValve.
TAVR may be a good treatment option for you if you have severe aortic stenosis and you're considered high-risk or are too sick for standard valve replacement surgery. Through clinical trials, Rush is able to offer TAVR as a potential option for anyone with severe aortic stenosis — even if you aren't experiencing symptoms, and if you are a good candidate for valve replacement surgery.
How Does TAVR Work?
The standard treatment for severe aortic stenosis is to remove the valve with open-heart surgery. TAVR does not require the chest to be opened surgically, and the diseased valve is not removed.
Here's how it works:
- The interventional cardiologist threads a collapsible replacement valve up to the heart using a catheter. The catheter is inserted through a tiny incision in either the groin or chest, depending on which entry point offers the easiest and safest path to the valve site.
- Instead of removing the faulty valve, the replacement valve is wedged into the valve site.
- The new valve expands to fit snugly inside the natural aortic valve once the catheter is pulled back, pushing the flaps of the natural valve aside.
- The replacement valve takes over the vital job of controlling blood flow away from the heart and preventing regurgitation (when blood mistakenly flows back into the heart).
Once the diseased valve is replaced, symptoms — including chest pain (angina) and shortness of breath (dyspnea) — should go away, and the prognosis is good.
Am I a Good Candidate for TAVR?
If you have been diagnosed with aortic stenosis, your doctor may refer you to a cardiologist who specializes in treating heart valve diseases, like the structural heart experts at Rush.
At the center, interventional cardiologists and cardiac surgeons pool their expertise to diagnose and treat aortic stenosis. You will have any necessary diagnostic tests, meet with the team and receive a customized treatment plan — all during the same visit.
Many factors go into the decision about which valve repair/replacement procedure is right for you, including your age, overall health and personal health goals. These are some reasons TAVR may be a good option:
- You are too frail to undergo standard surgery.
- You have other medical conditions that make you a higher risk for open-heart surgery, including a prior heart attack or a failing left ventricle.
- You had a bioprosthetic valve implanted in the past that is now failing, causing symptoms, and you have a high or greater risk with surgical valve replacement.
However, through clinical trials, any patient with aortic stenosis is now eligible to be considered for a TAVR procedure at Rush, including the following:
- People who have severe, calcific aortic stenosis but do not have symptoms
- Those with severe narrowing of the aortic valve who are considered low-risk for standard surgical aortic valve replacement
Rush Excellence in TAVR
- Expertise you can trust: Rush specialists have decades of experience helping to develop new treatments for heart valve disease, including aortic stenosis. This includes participating in clinical trials that led to TAVR, the Edwards SAPIEN valve and Medtronic CoreValve receiving FDA approval.
- Same-day treatment plans: You will meet with a team of specialists — including an interventional cardiologist and a cardiac surgeon — at the same time. For your convenience, the team will customize a treatment plan and present it to you during that same visit.
- State-of-the-art facilities: TAVR and other procedures used to treat aortic stenosis take place in Rush's interventional platform, a multi-use space where surgical and catheter-based procedures are centralized to allow specialists to collaborate more easily and ensure convenience for patients and families.
- Among the best in the U.S.: U.S. News & World Report ranked Rush University Medical Center among the best in the nation for cardiology.