What is TAVR?
TAVR (Transcatheter Aortic Valve Replacement) is a minimally invasive heart valve replacement procedure used to treat aortic valve stenosis. In this method, a new artificial valve is placed inside the narrowed aortic valve without requiring the opening of the chest cavity and open heart surgery, usually through the femoral vein in the leg’s groin area. TAVR is a modern treatment approach that is especially preferred for patients at high risk for open heart surgery, shortening hospital stay and accelerating the recovery process.
The TAVR procedure typically takes 1-2 hours, and patients are usually discharged within a few days. Transcatheter aortic valve replacement, which is especially preferred in patients with high risk for open heart surgery, provides fewer complications and a shorter recovery period.
Who is TAVR For?
Transcatheter aortic valve replacement is a treatment method preferred for patients with severe aortic stenosis who are at high risk for or unsuitable for open heart surgery. The high-risk group includes elderly patients and those with serious additional diseases (e.g., chronic lung disease, kidney failure, heart failure). In recent years, it has also begun to be applied to some patients with low surgical risk, but this is evaluated on a patient-specific basis. Anatomical suitability is also important; the patient’s aortic valve structure, vascular pathway status, and heart anatomy must be suitable for TAVR.
Who is TAVR Not For?
TAVR is not performed in cases of active infections, especially conditions like endocarditis (heart valve infection).
Patients with aortic valve diseases other than calcification, for example, those with rheumatic valve disease, may sometimes not be suitable for transcatheter aortic valve replacement.
If there are inappropriate vascular structures, i.e., vessels that are too narrow, twisted, or hardened to allow the catheter to progress, the procedure may not be possible.
Patients with severe aortic insufficiency (aortic regurgitation) are generally not considered suitable for TAVR, as the valves are not specifically designed for insufficiency.
For patients with other serious heart problems, such as mitral valve diseases or left ventricular thrombus, the best treatment method for the patient should be carefully evaluated.
Preparation for TAVR Procedure
Before transcatheter aortic valve replacement, the patient’s general health condition is evaluated in detail. During this process, echocardiography, computed tomography (CT) angiography, and other imaging methods may be used to examine the heart and vascular structure. The patient’s medications, medical history, and general health condition are carefully reviewed by the doctor.
Blood thinners or some medications may need to be adjusted before the procedure. Additionally, patients may be asked to fast for a certain period on the day of the procedure. Following the doctor’s instructions is of great importance for the safe and successful completion of the procedure.
How is TAVR Performed?
The TAVR procedure is usually performed under local anesthesia and is carried out with a thin catheter from the groin area (femoral artery) or chest wall. The catheter is carefully advanced along the vessel until it reaches the narrowed aortic valve. Then, the biological heart valve at the tip of the catheter is placed over the narrowed valve and expanded to replace the old valve. This procedure corrects blood flow and allows the heart to work more efficiently. The procedure usually takes 1-2 hours, and the patient can generally return to daily life in a short time.
Most patients can return to their daily activities within a few days after the transcatheter aortic valve replacement procedure. TAVR is an important option in the treatment of heart diseases due to its high success rate and minimal risk of complications.
TAVR Valve Types and Selection Criteria
Biological valve leaflets are generally used in the transcatheter aortic valve replacement procedure. These valve leaflets are selected based on the patient’s age, general health condition, and severity of valve disease. The lifespan of biological valves generally varies between 10-15 years, and the most suitable option is determined according to the patient’s condition. Patients using biological valve leaflets generally do not need to use long-term blood thinners. However, when mechanical valves are preferred, patients need to use blood thinners for life due to the long lifespan of these valves. This situation is an important criterion in the selection of valve type.
Recovery Process and Care After TAVR
The recovery process after transcatheter aortic valve replacement is generally fast and smooth. Patients stay in the hospital for a short time after the procedure, and most people can return to daily activities within a few days. However, the complete recovery process may take several weeks. During this period, it is important for patients not to miss their regular check-ups and to make lifestyle changes as recommended by the doctor. A healthy diet, light physical activities, and avoiding harmful habits such as smoking support the recovery process.
Advantages and Disadvantages of TAVR
One of the biggest advantages of TAVR is that it does not require open heart surgery and patients recover faster. Additionally, there is less risk of bleeding and complications during the procedure. However, TAVR also has some risks. These include vessel injury, bleeding, infection, stroke, heart attack, or displacement of the new valve. However, these risks are lower compared to open surgery. The possibility of complications is evaluated on a patient-specific basis.
What Should Be Done After TAVR Procedure?
Attention to lifestyle changes is necessary during the recovery process after the transcatheter aortic valve replacement procedure. A healthy diet, regular physical activity, and quitting smoking can increase the long-term success of the TAVR procedure. Regular use of the medications recommended by the doctor is also of great importance.
Frequently Asked Questions
How long does the transcatheter aortic valve replacement procedure take?
The procedure is usually completed in 1-2 hours. Since local anesthesia or mild sedation is used, the patient wakes up quickly after surgery. The hospital stay is mostly no more than a few days.
Are blood thinners used after transcatheter aortic valve replacement?
Lifelong blood thinners are generally not required in patients with biological valves. However, if the patient has other heart problems (such as atrial fibrillation), medication use may continue with doctor’s recommendation.
Up to what age can transcatheter aortic valve replacement be performed?
There is no definite age limit. Although advanced age (usually 75+) is an important criterion, the procedure can also be applied to younger patients with high surgical risk. The decision is made according to individual health status.
How long is the TAVR valve life?
The lifespan of biological valves is on average 10-15 years. This period may vary depending on factors such as age, valve structure, and patient life expectancy. Mechanical valves are more durable, but biological valves are generally preferred in TAVR.
Can sports be done after transcatheter aortic valve replacement?
Light exercises (walking, swimming) can be started with doctor’s approval a few weeks after the procedure. Heavy sports or competitive activities should be avoided. The physical activity plan is determined individually.
Reference: TAVR
