Transcatheter Aortic Valve Replacement (TAVR) Procedure

What Is TAVR?

TAVR is a minimally invasive procedure that treats aortic stenosis.

In this surgery, the doctor replaces a defective aortic valve with a biological tissue valve, often from a cow or pig. This allows your heart to keep working normally.

TAVR has a faster recovery time than open heart surgery, getting you back on your feet quicker.

UPMC was the first in the Pittsburgh region to perform the procedure.

_{Transcatheter aortic valve replacement is a less invasive approach for replacing a diseased aortic valve. This is performed through catheters placed in blood vessels in the groin, chest, or neck.} 

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Conditions We Treat with TAVR

Doctors use TAVR to treat people with aortic valve disease, including:

• Aortic stenosis.
• Aortic regurgitation.
• Rheumatic valve disease.

Who's a Candidate for TAVR?

Your care team at the UPMC Center for Heart Disease will decide if TAVR is right for you based on:

• Your age.
• Life expectancy.
• Your medical history.
• The condition of your arteries.

Since the catheter enters your heart through an artery typically in the groin, your arteries must be healthy.

Pre-op testing will help us learn your fitness for the procedure and make sure you're healthy enough for surgery.

What Are the Benefits of TAVR?

• Is a minimally invasive procedure that surgeons perform while the heart beats.
• Doesn't involve open-heart surgery or a heart-lung bypass machine.
• May aid in a faster, milder recovery.

What Are the Risks of TAVR?

Many people with severe aortic stenosis are at increased risk from surgery, complications, or death.

TAVR may provide a treatment pathway that would otherwise not be an option. But it may not be right for everyone.

TAVR is a surgical technique that involves sedation.

It carries a low risk of complications but, as with any surgery, there are some risks.

TAVR risks include:

• Stroke.
• Damage to the artery used for insertion of the valve.
• Need for a pacemaker.
• Major bleeding.
• Other serious life-threatening events or even death.

What to Expect Before, During, and After TAVR

When referred to the TAVR program, our team of heart valve experts will do a thorough exam.

If we decide TAVR is right for you, you may expect:

• Smaller incision or no incision at all, because there is no need to open the chest to perform open-heart surgery.
• Sedation, often used in place of general anesthesia.
• A shorter time in the operating room.
• A shorter hospital stay and faster recovery.

Before your procedure 

During your TAVR exam, you'll meet with:

• A heart surgeon.
• An interventional cardiologist.
• Advanced practice providers.

Testing for TAVR before, during, or after your visit may include:

• Echocardiogram (echo).
• Cardiac catheterization.
• CT scan.
• 5-meter gait speed.
• EKG.
• Lung function tests.
• Carotid ultrasound.
• Bloodwork and urine test to test for infection prior to valve replacement.

View or print our TAVR testing checklist (PDF) for more details.

On the day of your TAVR

On the day of your TAVR, before your surgery, you should expect to:

• Arrive at the hospital about two hours before.
• Meet with the heart valve team and anesthesiologist.
• Possibly have another EKG or more bloodwork.

Plan on spending around an hour in the operating room and one to two hours in the recovery room.

Then you'll go to a telemetry unit for heart monitoring overnight.

During your procedure 

During a TAVR procedure, your surgeon:

• Accesses an artery in your groin, neck, or side of your chest and inserts a catheter.
• Uses a special moving x-ray — called fluoroscopy — to guide the new valve to your heart and into the aortic valve.
• Opens the new valve. The new valve expands within your existing one and restores proper blood flow. 

Recovery and care after your TAVR

TAVR results in a faster recovery, proven in several large studies at UPMC and other health centers.

On average, people spend one to two nights in the hospital after TAVR.

When you go home, you'll need help from a family member or caregiver for the first few days.

Be sure to follow your care team's instructions to keep your heart healthy.

We'll call you within a week post-op to answer questions and make sure you're taking your medicine as prescribed.

You'll have follow-up exams and tests in the days and months after TAVR, including:

• An echo the day after.
• Outpatient bloodwork as ordered by your doctor.
• A valve center visit and echo about a month after.
• A follow-up visit and echo one year after TAVR.

What Is the Success Rate of TAVR?

UPMC is one of the top hospitals in the U.S. for performing TAVR, and our outcomes are among the best as well.

As we do more procedures, increase, success rates increase.

UPMC is in the top 1% in the U.S. in terms of the number of TAVRs we do. And our success rates are among the top in the nation as well.

Learn more about UPMC Heart and Vascular Institute volume and outcomes, including TAVR.

Why Choose UPMC for the TAVR Procedure?

UPMC was among the first U.S. hospitals to treat severe aortic stenosis with Edwards SAPIEN Transcatheter Heart Valve and Medtronic CoreValve®.

Our heart valve experts take part in research regularly. We've published many articles in leading journals about TAVR and its outcomes.

We also have ongoing clinical trials. This means you have access to the latest heart valve disease treatments.

Our Aortic Valve Disease Experts

Our team at the UPMC Center for Heart Valve Disease includes heart valve and heart surgery experts.

• A.J. Conrad Smith, MD, Medical Director, Center for Heart Valve Disease.
• Ibrahim Sultan, MD, Surgical Director, Center for Heart Valve Disease.
• Dustin Kliner, MD
• Amber Makani, MD
• Derek Serna-Gallegos, MD
• Catalin Toma, MD
• David West, MD

Advanced Practice Providers

• Elissa Castor PA-C
• Elizabeth Christensen, CRNP
• Kathryn Fatigante, MPAS, PA-C

We also have satellite sites for evaluation in Monroeville and at UPMC Jameson, UPMC Passavant, UPMC St. Margaret, and UPMC South Hills.