From an interview with
Dr. Brian Blaker
McLeod Cardiology Associates
As we age, our heart valves can become stiff or build up plaque and narrow severely. A minimally invasive procedure can repair a faulty valve without opening your chest or breaking ribs to get to the heart. McLeod Cardiologist Dr. Brian Blaker explains Transcatheter Aortic Valve Replacement (TAVR):
Here is an overview of Dr. Blaker’s remarks:
TAVR stands for “transcatheter aortic valve replacement.” It’s a method to replace a diseased aortic valve or a diseased prosthetic aortic valve by implanting a catheter-based valve. A catheter is inserted into the artery in the groin or occasionally in some other artery of the body. The wire is then advanced to the heart and across the problem aortic valve to position a new umbrella-like TAVR valve within the old valve. The valve is then expanded either with a balloon or through a self-expanding mechanism. The new valve takes over the function of the aortic valve controlling blood flow out of the heart.
Most of our patients who receive a TAVR valve are under moderate or conscious sedation, meaning they’re in an awake but sleepy and comfortable state. For 10%-15% of our patients, who are at increased risk or who might require additional procedures as part of their TAVR procedure, we use general anesthesia.
Traditionally, the TAVR procedure was indicated in patients who are at very high or intermediate risk for an aortic valve replacement. More recently, studies suggest that TAVR may be a reasonable option for those, who are at low surgical risk as well. Because it’s more recent data, we need to follow some of those patients long term to see how they handle the new valve. For now, I would encourage any patient with severe aortic valvular disease to talk to a cardiologist about the relative merits of either a surgical or a transcatheter-based approach.
Patients with severe aortic stenosis typically suffer severe fatigue. Often they will have shortness of breath, chest pain or a feeling of angina. At the very advanced stage, a patient may pass out. Any of those symptoms should prompt a person to seek a workup from a Cardiologist to identify the cause of those symptoms.
TAVR is often the preferred option for older patients, who may be at increased risk. But surgical aortic valve replacement is also an important tool, particularly in those patients who have abnormally structured valves or very leaky valves. So, while TAVR is a very important, less invasive procedure, it’s just one tool in the toolbox for aortic valve disease as a whole.
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