A Guide to Transcatheter Aortic Valve Replacement

Medically Reviewed By Uzochukwu Ibe, MD, MPH

Transcatheter aortic valve replacement (TAVR) is a procedure to replace the aortic valve in the heart. It is a treatment option for aortic stenosis. Compared to other treatments, TAVR is less invasive and may lead to a quicker recovery. TAVR is a minimally invasive treatment option for aortic stenosis. It involves placing an artificial valve into the heart along with a catheter.

TAVR can be effective and lead to a quicker recovery time. However, its benefits, risks, and outlook can vary per person.

This article discusses the benefits, risks, and outlook of TAVR. It also explains the procedure, including preparation and recovery.

What is transcatheter aortic valve replacement for?

A collage of an imaging scan of the chest, and a clinician using a stethoscope.
Nitat Termmee/Douglas Olivares/Getty Images, photo collage by Ebba Pero

TAVR can help treat aortic valve diseases, such as severe aortic stenosis.

The aortic valve is one of four main valves that controls blood flow in and out of the heart.

Standard aortic valve replacement procedures usually Trusted Source American Heart Association Highly respected national organization Go to source require open-heart surgery. 

TAVR is a minimally invasive procedure that doesn’t require open-heart surgery. However, it can still effectively improve heart health and function. As a result, TAVR may be useful for people who cannot undergo open-heart surgery.

TAVR involves inserting a thin catheter into a blood vessel elsewhere in the body and guiding it to the aortic valve. This allows doctors to secure a replacement valve, helping it stay open.

Preparation

Your medical team will inform you of anything specific you can do to prepare for a TAVR procedure. Possible preparations may include:

  • continuing or pausing your usual medications, depending on advice from your doctor
  • starting new medications
  • quitting smoking if you smoke
  • working with your doctor to optimize your physical activity levels or nutrition
  • keeping your teeth and gums clean and getting regular dental checkups

Procedure

A medical illustration of aortic stenosis and a transcatheter aortic valve replacement.
Illustration by Jason Hoffman

Doctors usually perform a TAVR procedure in a hospital. It can include the following steps:

  1. A nurse will place an intravenous (IV) line into a vein to provide medications. Your doctor or surgeon may also visit you to ask if you have any questions.
  2. Doctors will then administer anti-blood-clotting and pain relief medications, such as sedatives or local anesthetics.
  3. During the procedure, doctors will make a small cut to access a blood vessel elsewhere on the body.
  4. Through this incision, doctors will guide a thin, flexible catheter toward your heart. This catheter contains a small replacement valve.
  5. When the tube reaches the heart, doctors can securely place a folded replacement valve inside the aortic valve. They do this by inflating a small balloon at the end of the catheter to expand the valve. In some cases, the valve may expand by itself.
  6. Doctors will then check the valve’s placement for leaks or complications.

Most often, doctors access the heart from the femoral artery in the groin or thigh. However, they can also access the valve via the:

  • chest
  • stomach area
  • area under the collarbone
  • neck
  • septum of the heart, accessed via the thigh

Valve types

Your doctor may offer a choice between two valve replacement types, including:

  • Mechanical valves: Mechanical valves are made of synthetic materials. They may be less likely to require replacing as they can take longer to wear out. However, they may be linked to blood clots and require taking lifelong anti-blood-clotting medications.
  • Biological valves: Biological valves are made of animal tissues and may have a lower risk of causing blood clots. However, because they can wear out more quickly than mechanical valves, they may need replacement sooner.

Your doctor will work with you to find the best option for your condition.

Q: How long does transcatheter aortic valve replacement take?

Anonymous

A: Depending on your health center, a standard procedure can take around 1 hour or less.

Uzochukwu Ibe, M.D. Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Recovery

You may need to stay in the hospital for 1 or more days while you recover from TAVR. During this time, you may still be sedated for a few hours.

Recovery time can vary greatly per person and depend on factors such as:

  • the recovery approach
  • whether you experience any complications
  • your underlying health
  • your age
  • personal differences

It may take several weeks before you can return to certain activities. These can include driving, physical activity, and work. Your doctors will inform you when it is safe to resume these activities.

After TAVR, doctors may recommend Trusted Source AHA/ASA Journals Peer reviewed journal Go to source continued treatment, such as:

  • anti-blood-clotting medications
  • physiotherapy
  • regular checkups

Talk with your medical team if you have any questions between appointments.

Benefits

According to the NHS, TAVR may have the following benefits:

  • It may put less strain on the body than other aortic valve replacement techniques. This is because it doesn’t require stopping the heart.
  • It may be an effective alternative for people who find surgery difficult or risky.
  • It avoids making a large cut in the chest.
  • The recovery period may be faster than with other aortic valve replacement procedures.

Risks and side effects

TAVR can lead to complications or increase the risk of other health conditions, such as:

  • stroke or blood clots
  • bleeding
  • damage or injury
  • infection
  • leaking, due to unsuccessful valve placement 
  • wear on the valve, requiring a replacement
  • irregular heartbeat
  • kidney problems
  • damage to the heart’s electrical signaling, which may lead to the need for a pacemaker
  • rarely, coronary artery obstruction

The risk of stroke after TAVR may be higher than after standard aortic valve replacement surgeries.

Generally, TAVR may be more beneficial for your health than leaving aortic stenosis untreated. Your doctor can help you weigh the risks and benefits of the procedure.

Contact your doctor promptly if you experience any of the following symptoms:

  • redness or skin discoloration
  • swelling
  • worsening pain or bruising
  • fever
  • any other new, changing, or concerning symptoms after TAVR

Outlook

The British Heart Foundation suggests that most people see their symptoms improve after TAVR. This can mean relief from symptoms, improved quality of life, and improved ability to carry out daily tasks.

Less often, complications can occur. Rarely, some of these complications are fatal.

Steps you can take to help improve your outlook include:

  • getting regular physical activity
  • quitting smoking if you smoke
  • limiting alcohol
  • following your treatment plan as your doctor prescribes
  • keeping your teeth and gums healthy with proper brushing and regular dental checkups

Researchers are still investigating how long TAVR valves last, and their lifetime may vary per person. However, according to a 2023 literature review, clinicians expect most TAVR valves to last around 10–20 years Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source .

Talk with your doctor if you have questions about outlook with TAVR.

Summary

TAVR is a procedure that involves placing a replacement valve into the aortic valve of the heart via a catheter.

It is a minimally invasive procedure that can have a shorter recovery time than other surgical options. Still, you may require a recovery period of several weeks before you can resume all your usual activities.

As with any procedure, TAVR can have risks, such as an increased risk of stroke.

To reduce the risk of side effects and complications, your medical team will work with you to find the best treatment for your condition.

Contact your doctor promptly if you have any questions or experience any new or changing symptoms after TAVR.

Was this helpful?
23

Medical Reviewer: Uzochukwu Ibe, MD, MPH
Last Review Date: 2023 Sep 9
See All Aortic Valve Replacement Content
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.