TAVR - FAQ's Answered by a Cardiologist. What Is A TAVR (TAVI)?

TAVR is a revolutionary new heart valve treatment most commonly used to treat a tight aortic valve, otherwise known as aortic stenosis. TAVR stands for ‘transcatheter aortic valve replacement’, it is also commonly referred to as TAVI, which stands for ‘transcatheter aortic valve implantation’. TAVR and TAVI are the same thing. Transcatheter aortic valve replacement means that the procedure is done through a small tube (or catheter), rather than performing open- heart surgery. TAVR is similar to the mitraclip procedure for treating mitral regurgitation.

At myheart. net we’ve helped millions of people through our articles and answers. Now our authors are keeping readers up to date with cutting edge heart disease information through twitter. Follow Dr Ahmed on Twitter @Mustafa. Ahmed. MDFollow @Mustafa. Ahmed. MDThe aortic valve is the structure that resembles a fish’s mouth opening and closing. See how the aortic valve doesn’t completely open?

This is called Aortic Stenosis, the condition TAVR is intended to fix. Credit: Alliance for Aging Research. Most commonly the catheter is inserted through the groin and passed up through the blood vessels to the heart.

The new heart valve is then advanced through the tube into the correct position within the existing aortic valve. Sometimes, when the blood vessels in the leg are not suitable, the TAVR is done through different access points, such as the chest wall. How Is TAVR different From Conventional Aortic Valve Surgery? TAVR (TAVI) is without a doubt one of the biggest advancements in modern medicine. Since the 1. 95. 0’s surgeons have been able to operate on the aortic valve with open- heart surgery. Over decades surgical techniques have evolved to make open- heart aortic valve surgery safe and effective in those that require it. Typically aortic valve surgery requires patients to have a sternotomy incision (chest cracked open) and be placed on a heart- lung machine to provide access to the aortic valve.

No matter how safe or effective this is, it is clearly a big ordeal for the patient and physician. Because open- heart surgery carries serious risks, a large group of patients – particularly the elderly – are considered too high risk to undergo open- heart surgery. Unfortunately this group would die from their aortic valve disease.

That was until the transcatheter aortic valve replacement technology was developed. Unlike open- heart surgery, TAVR (TAVI) does not require patients to be placed on a heart- lung machine, and in the vast majority of cases, patients will not need their chest cracked open because the TAVR procedure is performed a catheter inserted through the skin. As you can imagine TAVR is generally much less of an ordeal than open- heart surgery, and so the patients that were previously felt too high risk for an operation now have an option that can improve symptoms and extend their length of life. How Does TAVR (TAVI) Work? The Other Woman Movie Watch Online there. In conventional open- heart surgery, when the aortic valve is replaced, the old valve is removed, and a new valve sewn into place.

In the TAVR procedure, the new valve is simply placed inside the existing valve, crushing it out the way. Since the TAVR procedure is done through a relatively small tube, the TAVR valve is compressed before put entering the body so it can fit into the tube. The new, artificial valve is then passed up to the correct position through the tube to the existing diseased aortic valve. Then the TAVR valve is expanded into its working size crushing the old valve out of the way. The artificial valve is advanced into place through a small tube known as a catheter. The new valve is then expanded in the correct position.

The new valve functions as a fully working aortic valve replacement. There are two main types of TAVR valves, balloon- expandable and self- expandable. In the balloon expandable type, the compressed valve is mounted on a balloon.

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Real world got you bummed out? Steam users recommend Slime Rancher. Most commonly the catheter is inserted through the groin and passed up through the blood vessels to the heart. The new heart valve is then advanced through the tube. We provide excellent essay writing service 24/7. Enjoy proficient essay writing and custom writing services provided by professional academic writers.

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When the balloon- expandable TAVR valve is in the correct position the balloon is inflated, enlarging the valve in the process to its normal working size. In the self- expandable type, the valve is contained within the tube like a compressed spring. As soon as the self- expandable TAVR valve is moved out of the tube  it automatically expands into its natural position.

The technology underlying these valves is simply incredible. Who Is Eligible For a TAVR? TAVR (TAVI) is a classic example of a continually evolving technology. Initially, TAVR was only approved for patients that were considered truly inoperable. Basically those patients that were being left to die from their aortic valve disease because the risk of operation was simply too high. Then as new research became available the indications for TAVR were expanded to include those at high surgical risk.

Currently in the US, TAVR is indicated for patients at high risk for open- heart surgery. Ongoing trials are investigating the use of TAVR in a healthier ‘intermediate- risk’ group. As things stand, for a patient with low or intermediate risk of undergoing a conventional operation, open- heart surgery is the preferred method of treating aortic valve disease such as aortic stenosis. TAVR is reserved for higher risk patients. So how is risk determined? In order to classify a patient as high risk, a TAVR heart team assesses aortic valve disease patients sent for consideration of TAVR.

This team consists of cardiologists, cardiac surgeons, and imaging specialists. Watch Crying Freeman Online Hulu. Together this team looks at each patient on a case- by- case basis and based on a number of factors decides if the patient fits into a high- risk category. Once the patient is determined to be high risk, they are assessed to determine their suitability for a TAVR procedure. Features that would make patients move towards a higher risk category include previous operation, lung disease, kidney disease, advanced age, and others.

Why Can’t All Patients With Aortic Valve Disease Have TAVR? As discussed above, the current indications for undergoing a TAVR procedure are for high- risk surgical patients; however, TAVR will liekly be available for patients deemed an intermediate risk in the next few years. But if the procedure is so non- invasive compared to conventional surgery, why aren’t we performing TAVR on everyone with aortic stenosis, even the low- risk patients? The reason is that it’s important as the technology expands to ensure that it is backed up by evidence. As tempting as it sounds to replace all aortic valve surgery with a TAVR procedure, there needs to be evidence that is beneficial and not harmful, not only in the short- term, but also the long- term. The good news is that trials in high- risk patients with aortic stenosis have demonstrated that, when compared to open- heart aortic surgery, TAVR is not only safe but results in improved quality and length of life.

There are ongoing trials looking at TAVR (TAVI) vs. When those trials complete, it is likely that TAVR will also be used on the intermediate risk group. So why not use TAVR in low- risk patients? When it comes to standard surgical aortic valve replacement, it has been tried and tested over time, and proven to be safe and effective with long- term durability. Until TAVR has been proven in studies to have good long- term durability and long- term outcomes it cannot be recommended routinely for lower risk patients with aortic valve disease.

Who Performs TAVR – Where Should You Have It Done? TAVR is a unique procedure in that it requires a unique approach called a heart team. A heart team includes cardiologists, cardiac surgeons, imaging specialists and other specialists to work in combination. The procedural selection, planning, and performance rely on these specialists working together. For this reason, TAVR should only be performed in a place with an established heart team in place and strong cardiac surgery and cardiology programs.