TAVR which is commonly known as Transcatheter aortic valve replacement is a medical procedure that helps in replacing narrowed aortic valve with an artificial valve. The condition of narrowed aortic valve is called as aortic valve stenosis, in this condition the aortic valve fails to open when required. The artificial valve is made from animal tissue and opens properly when required. Some people also call this replacement process TAVI i.e. transcatheter aortic valve implantation.
TAVR is highly recommended to patients who are at a higher risk of facing major complications from the open heart surgery. In simple words we can say that, the procedure is very helpful for people who are not medically fit to undergo the open heart surgery. The decision of performing transcatheter aortic valve replacement is taken only after detailed discussion with multiple doctors and heart surgeons. These doctors consider all the important aspect of patient health and then commonly decide the appropriate treatment option for the patient. Transcatheter aortic valve replacement procedure is very effective in eliminating all the painful symptoms of aortic valve stenosis, also it drastically increases the survival rate of patient who are suffering from this severe heart disorder, but are not recommended to undergo open heart surgery.
Broadly there are four important approaches of performing TAVR or transcatheter aortic valve replacement:
This is one of the simple and highly recommended approaches, which is used in more than 90% of the surgeries. In this procedure, a hollow tube like structure is firmly inserted in the groin or the femoral artery of the patient. Further, the artificial valve made from animal tissue in compressed form is placed in the catheter, which is slowly directed inside the affected aortic valve. Once the valve reaches the appropriate position, it expands automatically and all the catheters that are inserted in the patient’s body are removed one after the other.
This procedure is mainly performed by giving local anesthesia or pain medicines; it does not require endotracheal intubation or the general anesthesia. A team of specialists like cardiac anesthesiologists, interventional heart specialist, surgeon and imaging specialists work in sink to place valve successfully. This procedure is highly recommended to patients having small vessels in the pelvis, which is not enough to insert valve catheter.
Unlike the transfemoral Approach, this procedure is performed by giving general anesthesia and endotracheal tube. The procedure is performed only when the right or left subclavian arteries are big enough to pass the valve catheter. A minor cut is made above the subclavian artery through, which a hollow tube is passed to aorta. Animal tissue in compressed form is inserted in aorta through hollow tube and once the valve reaches the right position the valve expands. It is only when the valve starts to work properly hollow tube is slowly removed from the chest region.
This procedure is also conducted by giving general anesthesia and with the help of endotracheal tube. In this procedure, incision is made in the ribs region and then a light weight hollow tube is inserted in the opening of the heart. Like other procedures, once the valve reaches the required location it expands automatically and then the hollow tube is slowly removed from the body.
Like the above two procedures, Transaortic Approach is also performed with general anesthesia endotracheal tube. In this procedure, incision is made in J-shape and on the sternum. Further through this incision hollow tube is inserted into the patient’s body for placing artificial valve. After the compressed valve is placed properly the tube is removed successfully.