Transcatheter Aortic Valve Implantation/Replacement

Transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) are both effective treatments for aortic valve stenosis. In Australia, the decision between TAVR and SAVR is typically based on several factors, including:

• Patient’s age and overall health: TAVR is often preferred for older adults or those with multiple medical conditions who may be at higher risk for complications with traditional surgery.
• Valve anatomy: TAVR may be suitable for patients with certain valve shapes and sizes that make them higher risk for open-heart surgery. Some valve shapes and conditions are not suitable for TAVR.
• Patient preference: Some patients may prefer the less invasive nature of TAVR and the shorter recovery time compared to SAVR.

Ultimately, the decision between TAVR and SAVR is made between the patient and a Heart Team which includes your Cardiologist, a Cardiothoracic Surgeon, imaging specialist and specialist nurses, taking into account your individual circumstances and preferences.

Before undergoing TAVI/TAVR, you will likely undergo a number of pre-procedure tests including echocardiography, CT or computerised tomography scan, angiogram and blood tests to determine suitability. 

Prior to the procedure your Specialist will give detailed instructions on preparation. This may involve fasting and discontinuing certain medications. The procedure is usually performed in a specialized cardiac catheterization laboratory (Cath lab) under sedation or general anaesthesia.

During the procedure, a catheter is guided to the heart, where the new valve is positioned within the diseased valve and expanded, restoring normal blood flow. The entire procedure typically takes about one to two hours, and most patients are able to return home within a few days of the procedure.

While TAVI/TAVR is generally safe, there are potential risks, including:

• Bleeding or bruising at the catheter insertion site
• Infection
• Damage to blood vessels or surrounding structures
• Allergic reactions to medications or contrast dye
• Rarely, more serious complications such as stroke or heart rhythm disturbances

Your healthcare team will take precautions to minimize these risks and address any complications that may arise.

After TAVI/TAVR, you will be closely monitored in hospital to ensure your stability. Most patients experience significant improvement in symptoms such as shortness of breath and fatigue following the procedure. Your Specialist will provide instructions on post-procedure care, including medications, physical activity restrictions, and follow-up appointments. It’s important to attend all follow-up visits to monitor your progress and address any concerns.