Transcatheter Aortic Valve Replacement (TAVR)

Transcatheter aortic valve replacement (TAVR) is a procedure used to replace a narrowed aortic valve that doesn’t open fully. The aortic valve is located between the heart’s lower left chamber and the body’s main artery. Narrowing of the aortic valve is called aortic valve stenosis. This condition blocks or slows blood flow from the heart to the rest of the body.

TAVR is a minimally invasive procedure, meaning it involves smaller incisions compared to open-heart surgery. It may be an option for people who are not good candidates for traditional surgical valve replacement. TAVR can help relieve symptoms of aortic valve stenosis, such as chest pain and shortness of breath.

The decision to undergo TAVR is made after consultation with a multidisciplinary team of heart doctors and surgeons. This team works together to determine the best treatment option for you.

TAVR is also known as transcatheter aortic valve implantation (TAVI).

What is TAVR?

Transcatheter aortic valve replacement (TAVR) is a minimally invasive treatment for aortic valve stenosis. The procedure replaces the narrowed valve with a new one, typically made from animal tissue. This animation shows how TAVR is performed.

Why It’s Done

TAVR is used to treat aortic valve stenosis — a condition where the aortic valve becomes thickened, stiff, and narrowed. As a result, the valve cannot open fully, leading to reduced blood flow from the heart.

TAVR is an alternative to open-heart aortic valve replacement surgery. It usually results in a shorter hospital stay and recovery time compared to traditional surgery.

Your doctor may recommend TAVR if you have:

• Severe aortic stenosis with symptoms such as chest pain or shortness of breath.
• A failing biological tissue valve that needs replacement.
• Other health conditions, such as lung or kidney disease, that make open-heart surgery too risky.

Risks

All medical procedures carry some risks. Possible risks of TAVR include:

• Bleeding
• Blood vessel complications
• Problems with the replacement valve (e.g., leakage or dislodgement)
• Stroke
• Heart rhythm problems (which may require a pacemaker)
• Kidney damage
• Heart attack
• Infection
• Death

Studies have shown that the risks of disabling stroke and death are similar between TAVR and surgical aortic valve replacement.

How to Prepare

Your healthcare team will give you instructions on how to prepare for the procedure. Be sure to ask any questions you may have.

Food and Medications

Inform your healthcare team about all medications and supplements you take, including over-the-counter drugs. Let them know about any drug allergies.
Ask if and when you should take your regular medications before the procedure.
You will likely be asked not to eat or drink for a specific period before TAVR.

Clothing and Personal Items

Bring the following to the hospital:

• Eyeglasses, hearing aids, or dentures
• Personal care items (e.g., toothbrush, comb, shaving items)
• Loose, comfortable clothing
• Items to help you relax, such as books or music

Do not wear the following during the procedure:

• Contact lenses
• Dentures
• Eyeglasses
• Jewelry
• Nail polish

What to Expect

Before the Procedure

An IV line will be placed in your arm or hand. You’ll receive a sedative to help you relax, and medications may be given to prevent blood clots and infection.
Hair may be shaved from the area where the catheter will be inserted.

During the Procedure

A doctor will insert a catheter — a thin, flexible tube — into a blood vessel, usually in the groin or chest, and guide it to the heart using X-ray or imaging technology.
A replacement valve made from cow or pig tissue (a biological valve) is sent through the catheter and positioned inside the narrowed aortic valve. A balloon may be used to expand the new valve into place. Some valves are self-expanding.
Once the valve is properly positioned, the catheter is removed.

Throughout the procedure, your vital signs — including blood pressure, heart rate, and breathing — will be closely monitored.

After the Procedure

You may spend the first night in the intensive care unit (ICU) for close monitoring. Some patients are discharged the next day, depending on their condition.

Before going home, you’ll receive instructions on wound care and signs of infection to watch for, such as:

• Fever
• Increased pain, redness, swelling, or drainage at the catheter site

Medications prescribed after TAVR may include:

• Blood thinners (anticoagulants): To prevent blood clots. Take them exactly as directed by your healthcare team.
• Antibiotics: To treat or prevent infections. Since bacteria in the mouth can infect artificial valves, good oral hygiene and regular dental checkups are important. You may need antibiotics before certain dental procedures.

You’ll need regular follow-ups and imaging tests to ensure the new valve is functioning properly. Contact your doctor if you experience:

• Dizziness or lightheadedness
• Swelling in the ankles
• Sudden weight gain
• Unusual fatigue
• Signs of infection at the catheter site

Seek emergency care if you have:

• Chest pain, pressure, or tightness
• Sudden, severe shortness of breath
• Fainting

Results

TAVR can relieve symptoms of aortic valve stenosis and may significantly improve your quality of life.

To support recovery and maintain heart health after TAVR:

• Avoid smoking
• Follow a heart-healthy diet rich in fruits and vegetables, and low in salt and unhealthy fats
• Engage in regular physical activity — consult your doctor before starting a new exercise routine
• Maintain a healthy weight — ask your healthcare team what’s appropriate for you