Transcatheter aortic valve replacement (TAVR): Approach to Care

Image of Edwards SAPIEN Transcatheter Heart Valve, provided by EdwardsUniversity of Florida interventional cardiologists and cardiothoracic surgeons collaborate to provide Transcatheter Aortic Valve Replacement, TAVR, also known as a percutaneous minimally invasive valve procedure.

In November 2011 the U.S. Food and Drug Administration approved the use of the Edwards SAPIEN Transcatheter Heart Valve for adult patients with symptomatic severe native aortic stenosis who are not candidates for open heart surgery and in whom co-existing health conditions would not preclude the expected benefit from the correction of the aortic stenosis. Aortic stenosis is a condition in which the aortic valve narrows and over time requires the heart to work harder as it pushes blood through the narrowing valve. The extra strain on the left ventricle to pump blood can lead to heart failure, a heart attack or sudden death. The condition is typically followed conservatively over time until intervention is needed.

While the gold standard is to repair the valve through open heart surgery, TAVR offers a potential option to patients who previously had no other option to correct the condition. In the new TAVR procedure, the artificial valve – framed by a stent and wrapped around a balloon – is transported up to the aortic valve via a larger catheter in the leg. The new valve is then anchored into position inside the diseased valve by inflation of a balloon. Placement of the stent is monitored with X-ray and ultrasound imaging. The UF Health hybrid imaging and surgery suite is well-equipped to handle this revolutionary procedure.

It is important to note there are risks associated with the procedure, such as death, stroke, damage to the artery used for insertion of the valve, and major bleeding. In addition, how long the valve will function properly needs to be determined. Weighing the benefit versus risk is something the UF physicians will evaluate with each patient.