TAVR frequently asked questions

What is aortic stenosis?
How is the transcatheter aortic valve implanted?
Who is eligible for transcatheter aortic valve implantation?
What is the transcatheter aortic valve made of?
How does the valve stay in place?
Is a blood thinner required after valve implantation?
What studies and tests are needed to proceed?
How long will I be in the hospital after TAVR? What is required for anesthesia?
What are the risks of TAVR?
Does Providence Valve Center have a lot of experience with TAVR?
Whom do I call for more information?

What is aortic stenosis?
In elderly patients, severe symptomatic aortic stenosis is often caused by the build-up of calcium (mineral deposits) on the aortic valve’s leaflets (flaps of tissue that open and close to regulate the one-way flow of blood through the aortic valve). This build-up of calcium on the leaflets impairs the aortic valve’s ability to fully open and close.

As a result, the narrowed valve allows less oxygen-rich blood to flow from the lungs to the brain and rest of the body which may cause symptoms such as severe shortness of breath and extreme fatigue. There is no medical therapy for aortic stenosis; the valve can only be fixed by valve replacement.
 
How is the transcatheter aortic valve implanted?
Transcatheter aortic valve replacement (TAVR) enables the placement of a balloon-expandable heart valve into the body with a tube-based delivery system called a catheter. This tube-based system allows the valve to be inserted through an incision in the leg and into an artery (transfemoral procedure), or through an incision between the ribs and then through the bottom end of the heart called the apex (transapical procedure). The transapical procedure is available to certain high-risk patients who are not candidates for the transfemoral procedure because they do not have appropriate access through their leg artery.
 

 
Who is eligible for transcatheter aortic valve implantation?
Physicians from Providence Valve Center will conduct a comprehensive evaluation to determine whether the TAVR procedure is an appropriate therapeutic option.

In certain cases, TAVR may not be an option because of co-existing medical conditions or disease processes that would prevent the patient from experiencing the expected treatment benefit, or because the risks outweigh the benefits. For those who are candidates for TAVR, this therapy may provide relief from the often debilitating symptoms associated with severe symptomatic native aortic valve stenosis.
 
What is the transcatheter aortic valve made of?
The Edwards SAPIEN Transcatheter Heart Valve (THV) is made of cow tissue attached to a stainless steel mesh frame with a polyester wrap. The cow tissue is formed into valve leaflets that open and close to regulate the flow of blood in one direction.



How does the valve stay in place?
The SAPIEN valve is positioned via a catheter within the existing, narrowed aortic valve. Then the delivery balloon is used to expand the stainless steel frame of the SAPIEN valve and fix it in place. The balloon and delivery equipment are removed, leaving the new, functioning valve in place.
 

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Is a blood thinner required after valve implantation?
Typically patients are placed on antiplatelet agents including aspirin and clopidogrel (Plavix) for a short period after valve implantation. Blood thinners such as warfarin (coumadin) are not routinely required after TAVR.
 
What studies and tests are needed to proceed?
Providence Valve Center will coordinate several tests to determine eligibility for TAVR and to guide the procedure. These include an office visit with various heart specialists, an echocardiogram, a cardiac catheterization (if one has not been done recently), a CT scan of the aorta and arteries in the leg, ultrasound of the carotid (neck) arteries, and occasionally other tests. 
 
How long will I be in the hospital after TAVR? What is required for anesthesia?
The average hospital stay for TAVR patients ranges from three to seven days. General anesthesia is required for the TAVR procedure.
 
What are the risks of TAVR?
TAVR is a significant procedure involving general anesthesia, and placement of the valve is associated with specific contraindications as well as serious adverse effects, including risks of death, stroke, damage to the artery used for insertion of the valve, major bleeding, and other life-threatening and serious events. In addition, the longevity of the valve’s function is not yet known. 
 
Does Providence Valve Center have a lot of experience with TAVR?
At Providence Valve Center, we are proud to be first, and the largest TAVR program in the state.  Some other notable facts:
  • The first transfemoral TAVR in Oregon, Feb. 1, 2012
  • The first transapical TAVR in Oregon, Aug. 21, 2012
  • The first "valve-in-valve" TAVR in Oregon, Feb. 7, 2013
  • The highest volume TAVR program in Oregon
  • The only PARTNER II clinical trial site in Oregon
Because of this, Providence Valve Center:
  • Provides the latest-generation technology though the PARTNER II clinical trial
  • Provides the greatest number of transcatheter valve sizes available in Oregon
  • Provides treatment to the largest range of patients (intermediate risk to inoperable)
Whom do I call for more information?
Please contact Providence Valve Center at 503-216-0790, or ask your primary care physician or primary cardiologist for a referral to Providence Valve Center.