Transcatheter Aortic Valve Replacement (TAVR)
Transcatheter Aortic Valve Replacement (TAVR)
This procedure is for people who have been diagnosed with severe symptomatic
aortic stenosis and are at intermediate or greater risk for open heart surgery.
The TAVR procedure allows a new valve to be inserted within your diseased
aortic valve. The new valve will push the leaflets of your diseased valve
aside. The
frame will use the leaflets of your diseased valve to secure it in place.
This less invasive procedure is different than open heart surgery. TAVR
uses a catheter to replace the heart valve instead of opening up the chest
and completely removing the diseased valve. It can be performed in multiple ways.
VIDEO: This animated video shows an anatomical overview of what happens during
TAVR's transfemoral approach, which is performed through an incision
in your leg.
Please talk to a Heart Team to determine which treatment option is right for you.

Introduction
Aortic stenosis is a progressive disease that occurs with a narrowing of
the patient’s aortic valve opening. Aortic stenosis can be caused
by a birth defect, rheumatic fever, radiation therapy, or it can be related
to age. In fact, the prevalence of aortic stenosis increases with age.
It is estimated that approximately 2.5 million people, or 12.4% of the
population, in the United States over the age of 75 suffer from aortic stenosis.
Overview of the Disease
Human heart valves are remarkable structures. These tissue-paper thin membranes
attached to the heart wall constantly open and close to regulate blood
flow (causing the sound of a heartbeat). When there is a narrowing of
your heart's aortic valve opening, this is known as aortic stenosis.
This narrowing does not allow normal blood flow. It is most often caused
by age-related calcification, but can be caused by a birth defect, rheumatic
fever, or radiation therapy
In elderly patients, aortic stenosis is sometimes caused by the build-up
of calcium (mineral deposits) on the aortic valve's leaflets. Over
time, the leaflets become stiff, reducing their ability to fully open
and close. When the leaflets don't fully open, a person's heart
must work harder to push blood through the aortic valve to the rest of
the body. Eventually, the heart gets weaker, increasing the risk of heart
failure (heart cannot supply enough blood to the body).

If you have severe aortic stenosis and are experiencing symptoms, it can
be life-threatening and can progress rapidly.
Because the heart needs to work so much harder pumping blood through the
body, it may cause symptoms like severe shortness of breath and extreme fatigue.
However, it's important to know that heart valve disease may occur
with no outward symptoms.
While symptoms of aortic valve disease are more associated with severe
aortic stenosis, the symptoms are commonly misunderstood by patients as
‘normal’ signs of aging. Many patients initially appear asymptomatic,
but on closer examination up to 32% exhibit symptoms.
What are the signs of aortic stenosis?
You may notice symptoms like:
- Chest pain
- Fatigue
- Shortness of breath
- Lightheadedness, feeling dizzy, and/or fainting
- Difficulty when exercising
Major risk factors
Factors associated with aortic valve disease include the following:
- Increasing age
- High blood pressure
- High cholesterol
- Smoking
Severe aortic stenosis is life threatening, and treatment for this condition
is critical. Without aortic valve replacement, patients with severe aortic
stenosis have a survival rate as low as 50% at 2 years after the onset
of symptoms, and 20% at 5 years after the onset of symptoms.
Diagnosis
In addition to a physical exam, severe aortic stenosis is diagnosed in
several ways, the most common being: echocardiogram, electrocardiogram
(EKG), chest X-ray of the patient’s heart, and cardiac catheterization
(angiography).
Aortic Valve Replacement Options
Transcatheter Aortic Valve Replacement (TAVR)
TAVR (sometimes called transcatheter aortic valve implantation, or TAVI),
is a less invasive procedure which allows a new valve to be inserted within
the native, diseased aortic valve.
The TAVR procedure can be performed using one of many approaches, the most
common being the transfemoral approach (through a small incision in the
leg). Only a Heart Team can decide which approach is best, based on the
patient’s medical condition and other factors.
In preparation for the patient’s procedure, the patient may be placed
under anesthesia. The doctor will make an incision in the leg, and will
insert a short hollow tube called a sheath. This will allow the doctor
to put various devices through the sheath to access the patient’s
heart. The heart valve is placed on the delivery system, and compressed
onto a balloon to make it small enough to fit through the sheath. Once
the delivery system reaches the patient’s diseased valve, the balloon
will be inflated with fluid, expanding the new valve into place. The new
valve pushes the leaflets of the patient’s diseased valve aside,
and the frame of the new valve uses the diseased valve’s leaflets
to secure itself in place. The balloon is then deflated and removed. The
patient’s doctor will ensure the new valve is working properly before
closing up the incision.
The TAVR procedure may involve general anesthesia and is associated with
specific contraindications as well as adverse effects, including risks
of death, stroke, major vascular complications and major bleeding, and
other life-threatening and serious events. To see a full list of warnings
and precautions, please visit SAPIEN3.com.
Open-Heart Surgery
During open-heart surgery, the surgeon removes the diseased aortic valve
and replaces it with either a mechanical valve (made from man-made materials)
or a biological valve (made from animal or human tissue).
Additional Information
To review all important risks for the SAPIEN 3 valve, please visit
www.SAPIEN3.com.
More information about the TAVR procedure can be found at
www.NewHeartValve.com.