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Structural Heart Disease Program

Transcatheter Aortic Valve Replacement

An innovative and minimally invasive procedure.

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 1300 TAVR valves – more than any other hospital in Delaware.

 

While TAVR was originally developed specifically for patients at high risk with open-heart surgery, it's now approved for anyone with severe aortic stenosis 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 Team

Personalized Care Plan

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.

Group photo of ChristianaCare TAVR team

Request an Appointment

To request an appointment, complete the form below or call us at 302-733-1507.

TAVR Procedure

TAVR procedures are completed at the Christiana Hospital campus in Newark, DE.

The procedures are done in the hybrid operating room which offers state of the art technology and advanced imaging equipment to ensure that your new valve travels safely to the heart and is placed precisely.

In order to perform TAVR, your team will determine what type of anesthesia is best for you. Your cardiac anesthesia team may keep you fully asleep under general anesthesia or you may be given sedation that keeps you relaxed and not feel pain, but still remain awake.   During a TAVR, a team of physicians including an Interventional Cardiologist and a Cardiac Surgeon will insert a catheter into the aortic valve and replace it with a biological (made from animal tissue) valve. A catheter is a long, thin, flexible tube that is inserted through the skin into an artery in the leg (groin) and guided to the heart. During the procedure, real time X-ray (Fluoroscopy) and IV Contrast is used to see where the catheter is located within the heart. Once the catheter is positioned in the aortic valve, a new valve is placed over the diseased valve.

The team then evaluates the new valve function by performing an ultrasound of the heart. The team then closes the incision in the groin by either using stitches, a closure device, a plug or holds manual pressure over the groin site to prevent any bleeding. Some patients have small or calcified arteries in the groin (Femoral artery) which may make a percutaneous TAVR difficult. These patients may require the TAVR to be performed using a small incision in the upper chest using the subclavian artery (incision near the shoulder), transapical (incision in the chest between the ribs), transcarotid (incision low in the neck) or transaortic(incision in the upper chest).

 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 Heart and Vascular Prep & Holding unit. You will be monitored closely to ensure you are recovering properly. After a couple of hours, you will be transferred to a cardiac stepdown floor for continued monitoring. 

The average hospital stay following TAVR is typically one to  two 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.

Recovery in our Award Winning Complex

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.

Average Stay is 1-3 days

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 Care

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.

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At ChristianaCare innovating in health means more than just developing new medicines. It also means creating equipment to assist in diagnosis, monitoring, and treatment.
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