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Transcatheter Aortic Valve Replacement

AMBULATORY CARE:

What you need to know about a TAVR:

  • A TAVR is a procedure to replace your aortic valve. It is done without removing your old valve. The aortic valve is between the left ventricle and the aorta. The left ventricle is the lower left chamber of your heart. The aorta is a blood vessel that pumps blood to your brain and body. The aortic valve opens and closes to let blood flow from your heart to the rest of your body.
  • TAVR may be used to replace your aortic valve if open heart surgery is not safe for you. Your valve will be replaced with a tissue valve. The tissue may be taken from an animal, such as a pig or cow.

What will happen before a TAVR:

  • You may need an echocardiogram, angiogram, EKG, or CT scan before your procedure. These tests will help your healthcare provider plan your procedure. They will also make sure a TAVR is safe for you. You may need to stop taking blood thinner medicine several days before your procedure. This will prevent heavy bleeding during your procedure.
  • Your healthcare provider will talk to you about how to prepare for your procedure. He may tell you not to eat or drink anything after midnight on the day of your procedure. He will tell you what medicines to take or not take on the day of your procedure. You may stay in the hospital 2 to 5 days after your procedure. Arrange for someone to drive you home and stay with you. This person can call 911 if you have problems at home.

What will happen during a TAVR:

  • You may be given general anesthesia to keep you asleep and free from pain during your procedure. You may instead be given IV sedation and local anesthesia. IV sedation will make you feel calm and relaxed during the procedure. With local anesthesia, you may still feel pressure or pushing during your procedure, but you should not feel any pain. You may be given an antibiotic through your IV to prevent a bacterial infection. Tell healthcare providers if you have ever had an allergic reaction to an antibiotic.
  • Your healthcare provider will make an incision in your neck, groin, or chest. He will guide a catheter with a balloon on the end through a blood vessel and into your heart. He will inflate the balloon in the opening of your valve. This balloon make space for your new valve to fit inside the old one. The balloon will be deflated and the catheter will be removed.
  • Your healthcare provider will insert another catheter into your heart. This catheter will hold a balloon, a stent, and the new valve. The new valve will be inside of the stent. When the catheter reaches your valve, your healthcare provider will expand the balloon. The balloon will push your old valve against the walls of your heart. The stent and new valve will be put in the old valve's position. The balloon will be deflated. The stent will continue to hold your old valve out of the way. It will also keep your new valve in the correct place.
  • Your healthcare provider will remove the catheter and wire. He may use clamps, stitches, or other devices to close the incision. Pressure will be applied to the incision for several minutes to stop any bleeding. A pressure bandage or other pressure device may be placed over the incision to help prevent more bleeding.

What will happen after a TAVR:

  • Healthcare providers will monitor your vital signs and pulses in your arm or leg, closely. They will check your pressure bandage for bleeding or swelling. You will need to lie flat with your leg or arm straight for 2 to 4 hours. Do not get out of bed until healthcare providers says it is okay. Arm or leg movements can cause serious bleeding.
  • You may need blood tests, a chest x-ray, an EKG, or an echocardiogram before you leave the hospital. These tests will make sure your valve is working correctly. You will need to take blood thinner medicine for at least 6 months after your procedure. You may need to take aspirin for the rest of your life. These medicines will prevent blood clots from forming near your valve.

Risks of a TAVR:

You may have bruising or pain where the catheter was. You may get an infection or bleed more than expected. The catheter may cause a hole in your heart or blood vessels. A blood clot may form around your valve. The clot may travel to your brain and cause a stroke. Your heartbeat may become irregular during or after a TAVR. You may need medicines or procedures to treat this. Your new valve may not work correctly. You may need another procedure to replace the valve.

Follow up with your healthcare provider as directed:

Write down your questions so you remember to ask them during your visits.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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