Transcatheter Aortic Valve Replacement (TAVR)

The aortic valve is one of four valves that regulate blood flow through the heart. The aortic valve opens so blood can flow out. It then closes to ensure blood is only moving forward. In aortic stenosis, however, the aortic valve is narrowed. Because of this the heart has to work harder than it should to pump blood to your body.

Transcatheter aortic valve replacement (TAVR) is a minimally-invasive procedure (small incisions of 2–3 inches long / general anesthesia) performed to replace a narrowed aortic valve that fails to open properly. TAVR may also be an option for people who are considered at intermediate or high-risk of complications from surgical aortic valve replacement. TAVR may also be indicated in certain people who can’t undergo open-heart surgery (large incisions of 8-10 inches long / general anesthesia). Your doctor will discuss all of the options with you and make the make the best decision based on your health condition.

How to prepare for the procedure

Prior to a TAVR procedure, your doctor and treatment team will explain to you what to expect before, during, and after the procedure and potential risks of the procedure. Other recommendations include:

Talk to your doctor about

  • All medications, herbal products and dietary supplements you are currently taking and ask for their recommendations about each.
  • Diabetes and how to adjust your medicine on the day of the procedure
  • Radiation exposure, especially for those that are pregnant
  • Any allergies to medicines, latex, tape, iodine, and anesthetic agents
  • Any history of bleeding disorders
  • Any implanted device (e.g. pacemaker or ICD)
  • Any body piercings on your chest or abdomen

Other suggestions

  • Eat a normal meal the evening before the procedure. However, do not eat, drink or chew anything after midnight before your procedure. If you must take medications, only take them with sips of water.
  • Leave all jewelry at home
  • Remove all makeup and nail polish
  • Wear comfortable clothing when you come to the hospital.
  • If you normally wear dentures, glasses, or hearing devices at home, plan to wear them during the procedure.

What to expect before the procedure

Before the procedure, your doctor may perform a variety of tests, including:

Diagnostic tests and procedures

What to expect during the procedure

This animation shows an Aortic Valve Replacement procedure in which the SAPIEN valve is inserted to replace a faulty aortic valve.

The TAVR procedure usually takes 2 hours, but the preparation and recovery time may add several hours. This procedure is usually performed in the cardiothoracic operating room (OR). Check with your doctor about the details of the procedure. In general:

  • You will change into a hospital gown.
  • A nurse will start the intravenous (IV) line in your arm which will administer medications and fluids during the procedure.
  • Prior to starting the procedure, you will receive a local anesthetic to numb the catheter insertion site(s). Sites include: subclavian approach (incision near the shoulder), transapical (incisions in the chest between the ribs), transaortic (incision in the upper chest), or transfemoral (incision in the groin).
  • The transfemoral approach is usually the most commonly used.
  • Once the local anesthetic has taken effect, a catheter (which includes a compressed heart valve in it) will be inserted and guided directly inside the diseased aortic valve.
  • Once in position, the new valve is expanded.
  • Once the valve is securely in place, the catheter will be removed from your body and the incision in your leg will be closed with a closure device or sutures.

What to expect after the procedure

After the procedure, you will be taken to the cardiothoracic intensive care unit (CTICU) for further observation. Generally, you’ll spend about 2 to 5 days recovering in the hospital. Other recommendations include:

General guidelines

  • A nurse will monitor your vital signs, the insertion site, and circulation and sensation in the affected leg or arm.
  • You must stay in bed as long as recommended by your doctor.
  • Tell your nurse right away if you feel any chest pain or tightness, or any other pain, as well as any feelings of warmth, bleeding, or pain at the insertion site.
  • Your doctor will give you instructions to follow during your recovery.

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Early TAVR

Saint Barnabas Medical Center
94 Old Short Hills Road
Livingston, NJ 07039
(973) 322-5000
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Newark Beth Israel Medical Center
201 Lyons Avenue at Osborne Terrace
Newark, NJ 07112
(973) 926-7000
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Jersey City Medical Center
355 Grand Street
Jersey City, NJ 07302
(201) 915-2000
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Robert Wood Johnson University Hospital
1 Robert Wood Johnson Place
New Brunswick, NJ 08901
(732) 828-3000
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Transcatheter Aortic Valve Replacement (TAVR) Treatment & Care

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