TAVR (Transcatheter Aortic Valve Replacement)
What is Aortic Stenosis?
Aortic stenosis is the narrowing of one of the heart’s valves that controls blood flow from the heart to the rest of the body. It is a serious problem that can lead to heart failure, permanent damage to the heart and even death. Patients who have severe aortic stenosis may have symptoms such as shortness of breath, fatigue, dizziness, and chest tightness or chest pain. These symptoms can limit daily activities, including walking, climbing stairs or performing simple household chores.
TAVR at ChristianaCare
Traditionally, surgeons performed open heart surgery to replace the aortic valve. However in November of 2011, the FDA approved TAVR, an innovative and minimally invasive procedure and ChristianaCare launched our TAVR program that same month. Since its inception, our heart team has implanted over 500 TAVR valves – more than any other hospital in Delaware.
TAVR is approved for patients considered at medium or high risk for surgical aortic valve replacement or those who are considered inoperable by the heart team. If you have this condition and your physician thinks you are a good candidate for TAVR, there are several reasons to consider this option, including:
- A shorter stay in the hospital.
- Reduced recovery time at home.
- The chance to improve your heart’s function and your quality of life.
Our structural heart team works together to come up with a personalized care plan specific to your needs. The heart team is comprised of interventional cardiologists, cardiac surgeons and noninvasive cardiologists. Our structural heart nurse coordinators are here to help guide you through your evaluation process, including all appointments and testing. Once you have completed your workup, the multidisciplinary team will decide if TAVR is the best option for you.
The TAVR Procedure and Recovery
TAVR procedures are completed at the Christiana Hospital campus in Newark, DE. The procedures are done in either the hybrid operating room or in one of our cardiac catheterization labs. These rooms offer state of the art technology and advanced imaging equipment to ensure that your new valve travels safely to the heart and is placed precisely. To begin the procedure, an interventional cardiologist and cardiac surgeon thread a catheter (thin, flexible tube) to the heart through an artery in your leg or chest. They then insert the compressed heart valve in the catheter and guide it up until it is directly positioned inside of the diseased valve. The new valve is expanded, which also secures it in place. Once the valve is securely in place, all of the catheters are removed. The artificial valve performs like a real, functioning valve.
In order to perform TAVR, you will be put to sleep under anesthesia by our highly trained cardiac anesthesia team. The procedure takes two to three hours to complete. Your family and loved-ones will wait for you in our cardiac family waiting room located on the second floor E Tower, close to the elevators. There you will find tracking screens that update to show your loved one’s progression from the pre-procedure area through to recovery. ‘
After the procedure is over, you will recover in our award-winning Cardiovascular Critical Care Complex (CVCCC) located on the second floor of the Heart and Vascular E Tower. The CVCCC at ChristianaCare received the Gold Level Beacon Award for Excellence from the American Association of Critical Care Nurses (AACN). The Beacon Award for Excellence recognizes nursing units for their high standards in patient outcomes, staff recruitment and retention, staff training and a healthy work environment. The CVCCC first earned the gold honor — the highest recognition of the critical care nursing profession — in 2013 and has continued this standard of excellence with consecutive awards over the past several years.
The average hospital stay following TAVR is typically one to three days. You will stay under the care of the heart team and meet with other members of the multidisciplinary team, such as cardiac rehab and case management, to help prepare you for your transition out of the hospital. Each person may recover differently, and your care team will plan your discharge when they feel you are ready.
After you go home, our team will monitor you throughout the recovery process with necessary follow-up appointments. We will provide you with a comprehensive discharge guide and discuss with you all the things you need to do to make sure your recovery goes smoothly. Our team is always available to answer your questions and help you any way we can after your procedure.