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Watch this animation to learn more about a new, less invasive procedure for replacing the aortic valve called transcatheter aortic valve implantation or TAVR. (Animation provided courtesy of Medtronic.)
Transcatheter aortic valve replacement (TAVR), is a new procedure that was recently approved for some patients. It is used to replace a patient’s aortic heart valve without open-heart surgery. Instead of opening the chest, a flexible tube called a catheter is used to access the faulty valve.
While open-heart surgery is still the treatment option of choice for most patients, TAVR offers a good second choice option for high-risk patients and is perhaps the only option for patients who are too high risk for surgery. If you are older, frail, have an extensive history of other illnesses (for example, a history of stroke, lung disease, kidney disease, or heart attack http://www.scai.org/SecondsCount/Disease/HeartAttack.aspx), or are medically debilitated due to non-heart-related issues, such as radiation to the chest for cancer treatment, you may not be a good candidate for traditional open-heart surgery to replace a valve.
Based on the data from the PARTNER clinical trial, patients whose valves are replaced with this TAVR are living significantly longer with a 20 percent reduction in death rate as well as improved quality of life. For patients facing a 50 percent chance of dying within three years of their diagnosis, this benefit is hard to beat. In fact, few other treatments offer such a significant of a reduction in mortality - including treatments for heart attack.
Although the risk of stroke and other complications, such as bleeding, is greater for people who undergo TAVR, on balance, based on the overall population studied in PARTNER, even when you take all those risks into account, there is a still a 20 percent reduction in mortality in the first couple of years.
Ongoing advances in technology are expected to continue to improve the outcomes of these procedures. Miniaturization of the devices used in the procedure and technical modifications continue to improve TAVR’s safety and reduce the risk of bleeding.
Unfortunately, even though a less invasive approach such as TAVR may sound appealing to everyone who needs valve replacement surgery, until the risk of stroke and other complications of the procedure are reduced, open-heart surgery is still the treatment option of choice for most patients.