Aortic stenosis occurs when the aortic valve narrows and limits blood flow to the heart. It’s usually caused by age-related scarring and calcium buildup in the valve leaflets (flaps that open to allow blood flow). The standard of care for AS for the past 60 years has been open-heart surgery to replace the damaged valve, but, for some patients, open-heart surgery is too risky.
Transcatheter aortic valve replacement now provides an alternative to open-heart surgery. Approved by the Federal Drug Administration in 2011, TAVR has demonstrated its effectiveness in multiple, large, randomized, multi-center trials during the past eight years. The results show a decrease in mortality, improved symptoms and a better quality of life for patients.
Traditional open-heart surgery is a several-hour procedure that requires general anesthesia and involves opening up the chest plate to cut out the old valve and sew in a new one. Recovery is often one week in the hospital, and most patients will be unable to resume a normal lifestyle for several more weeks or even months. During TAVR, a catheter threaded from the groin places a new valve in the heart, expanding the new valve and displacing the faulty one. Patients are generally lightly sedated, but are awake and can talk during the procedure, which takes 30 minutes. Recovery typically consists of one or two days in the hospital, and patients can often resume normal activities soon after.
Last year the number of TAVR procedures eclipsed traditional open-heart surgery. With its growing success rate, doctors are investigating the long-term effects of the minimally invasive procedure, as well as whether it’s also appropriate for people who are eligible for open-heart surgery.
Dr. Pedro R. Cox-Alomar, M.D.