TAVR (Transcatheter Aortic Valve Replacement)

What is a TAVR procedure?

Transcatheter Aortic Valve Replacement (TAVR) is for select patients with severe symptomatic aortic stenosis — a narrowing of the aortic valve opening.

TAVR is an FDA approved procedure for the replacement of the aortic heart valve. A catheter is inserted through a large artery in the leg and threaded up to the aortic valve. A valve on the end of the catheter is then inserted into the opening of the valve.

In the early days of the TAVR procedure, it was limited to patients who were considered extremely high-risk surgical patients because of their age, co-morbidities, frailty or severe heart disease. Shipley is proud of the role we have played in the evolution of the TAVR procedure, and our participation in clinical trials that now make TAVR available to any patient who needs aortic valve replacement.

TAVR: A Minimally Invasive Approach That Can Save a Life

John Essler didn’t even realize how bad things were until after his surgery. “I felt tired in the evening, like 8 o’clock it was time to go to bed. I never noticed that. It was like two or three days after the surgery that I realized ‘you know what, I don’t feel that way anymore.’”

He had aortic stenosis, or plaque buildup that blocks blood flow from the heart to the rest of the body. “The heart grows to compensate for that. Like any muscle if it’s working harder, it grows bigger, and then eventually can compromise the blood supply to the heart which can cause heart failure,” said Cardiothoracic Surgeon Dr. David Cervantes.

The Shipley Cardiothoracic center at Lee Health was the first program in the state, and second in the country to conduct the minimally invasive TAVR procedure. “We usually go in through the groin, using a catheter about the width of my pinky. We sneak it up through the aorta across the aortic valve, where we deployed carefully to open up the aortic valve,” said Dr. Cervantes.

Dr. Cervantes said it’s one of the most rewarding procedures he does, since patients typically feel better the very next day. His patient, John Essler agrees, “(I had) No pain at all. Surgery was Thursday, Friday I was released, Saturday I was walking and biking. He said it has given him a new lease on life. “At 76 I’m in the last quarter looking for overtime. That’s the way I look at it. Maybe the game can go on a little longer.”

You can learn more about TAVR by searching for it on leehealth.org.

View More Health Matters video segments at LeeHealth.org/Healthmatters/

Lee Health in Fort Myers, FL is the largest network of health care facilities in Southwest Florida and is highly respected for its expertise, innovation and quality of care. For more than 100 years, we’ve been providing our community with personalized preventative health services and primary care to highly specialized care services and robotic assisted surgeries. Lee Health - Caring People. Inspiring Care.

How is it done?

The TAVR valve leaflets are made of bovine (cow) heart tissue, and are stitched inside of an expandable nickel-nitinol scaffold, or stent.

During the TAVR procedure, the new valve is crimped down to the approximate diameter of a pencil and placed on a catheter. A small incision is made in the groin, and the catheter is fed through the femoral artery to the heart, much like an angioplasty (cardiac catheterization) procedure. Once in the heart chamber, the new valve is positioned directly inside the diseased aortic valve, where the catheter sheath is extracted, and the new valve expands in place. The valve will begin to work immediately, functioning like a normal, healthy valve.

The TAVR procedure is performed under conscious sedation, in a hybrid operating room. A cardiothoracic surgeon and an interventional cardiologist work together, utilizing fluoroscopy and echocardiography to guide the valve to the site of the patient's diseased heart valve.

The TAVR procedure generally is performed in much less time than open-heart surgery, approximately an hour and a half. Additionally, open-heart surgery can require a two- to three-month recovery period, compared to the recovery period of only a few days with the transcatheter approach. Many of our TAVR patients go home the day after the procedure.

TAVR criteria

Any patient diagnosed with severe aortic stenosis can be referred by their cardiologist to Shipley’s structural heart program clinic for TAVR evaluation.

All potential candidates will be assessed and educated by our specially trained team, consisting of a cardiothoracic surgeon, an interventional cardiologist and a Nurse Navigator. Together they will conduct a comprehensive evaluation to determine whether this procedure is an appropriate option for the patient.

If we find that you are a candidate for the TAVR procedure, you will be given specific instructions and scheduled for surgery at HealthPark Medical Center.

Risks

While less invasive than open heart surgical aortic valve replacement, TAVR still has the potential for similar adverse effects, including risk of death, stroke, damage to the artery used for replacement of the valve, major bleeding, and other life-threatening and serious events. While the risks are very low, they still exist.

Technology and expertise at Lee Health

Following FDA approval in late 2011, Shipley Center was the first program in Florida to perform the TAVR procedure. Since that time we have performed over 2,000 TAVRs.

Lee Health provides the most advanced valve replacement surgeries and treatments using a multidisciplinary approach. Our structural heart program regularly handles the most complex cases in the region with excellent outcomes.

Contact Us Today!

Cardiothoracic Surgery - Heart Institute at Shipley Cardiothoracic Center

9981 S HealthPark Dr, Suite 156 Fort Myers, FL 33908

Fax: (239) 343-6342

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