Are You a Good Candidate for TAVR?

By

Sarah Lewis, PharmD

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TAVR (transcatheter aortic valve replacement) treats severe aortic valve stenosis—or narrowing. The aortic valve opens to allow blood to flow out of the heart to the rest of the body. TAVR is also known as TAVI (transcatheter aortic valve implantation).

TAVR is a minimally invasive method of inserting a functional valve to restore blood flow. The goal of TAVR is to relieve symptoms of severe aortic stenosis in people who are not good candidates for conventional aortic valve replacement by means of open heart surgery. 

Are there other treatment options?

In most cases, doctors recommend less invasive treatments to treat the symptoms of aortic stenosis. Less invasive treatments include medicines to lower blood pressure, control heart rhythms, lower heart rate, and eliminate extra fluids. These measures reduce the amount of work your heart has to do.

Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on TAVR. It’s possible your insurance company will require a second opinion before they will cover TAVR versus conventional aortic valve replacement.

When to Consider TAVR

Your doctor may decide you are a good candidate for TAVR if:

  • Your aortic stenosis is severe.

  • You are experiencing symptoms including chest pain, heart failure, fainting, and irregular heart rhythms.

  • Medications have not improved your symptoms.

  • You are at intermediate to high risk of complications from traditional open heart surgery.

  • You are not a candidate for traditional open heart surgery because you have another serious medical condition, such as kidney disease, lung disease, or diabetes.

  • You are not a candidate for traditional open heart surgery due to previous open heart or other heart surgeries.

Who is NOT a good candidate for TAVR?

You may not be a good candidate if:

  • Your valve and blood vessels are not the right size for TAVR.
  • Your heart is too weak or you have other untreated heart problems.
  • You have problems with your aorta.
  • You have had a heart attack in the last 30 days.
  • You have a severe illness or infection.

Your doctor is the best person to help you make the decision as to whether TAVR is a good option for you. Your doctor considers different types of information in making a recommendation for or against TAVR. Your medical history, test results, lifestyle, and personal preference all play a role.  

What to Expect

A surgeon performs TAVR by inserting a catheter through a blood vessel in your groin. Some surgeons use an alternate site besides the groin. The doctor guides the catheter to the aortic valve and places a new valve without removing the old valve.

You will have general anesthesia, and you may need to stay in the hospital for 4 to 7 days. The first part of your hospital stay will include time in an ICU (intensive care unit).

Cardiac rehabilitation is usually part of your recovery. And you will need help with household, work, and other daily activities for a time. Gradually, you’ll get back on your feet and doing activities you enjoy. Full recovery takes up to six months.

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Nov 1, 2016

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Medical References

  1. Benefits and Risks of Coronary Bypass Surgery. Society for Cardiovascular Angiography and Interventions. http://www.scai.org/SecondsCount/Resources/Detail.aspx?cid=b240bd15-dca5-4aaf-98e4-99bd116cd4ce#.VCs...
  2. Criteria for Transcatheter Aortic Valve Replacement (TAVR). Robert Wood Johnson University Hospital. http://www.rwjuh.edu/tavr/criteria-tavr.aspx
  3. Is Your Patient Elligible for TAVR? West Tennessee Heart and Vascular Center. http://www.wthvc.org/heart-vascular-center/areas-of-expertise/valve-clinic/tavr-eligibility
  4. Transcatheter Aortic Valve Replacement (TAVR). Cleveland Clinic. http://my.clevelandclinic.org/heart/percutaneous/percutaneousvalve.aspx
  5. Transcatheter Aortic Valve Replacement (TAVR or TAVI). American Heart Association. http://www.heart.org/HEARTORG/Conditions/More/HeartValveProblemsandDisease/Transcatheter-Aortic-Valv...
  6. Who Is a Candidate for TAVR? Main Line Health Lankenau Heart Institute. http://www.mainlinehealth.org/heart/services/valve/tavr-candidate

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