Transcatheter Aortic Valve Replacement

Recognized by U.S. News & World Report

UT Southwestern Medical Center has earned a "High Performing" rating from U.S. News & World Report for transcatheter aortic valve surgery (TAVR), placing us among the nation’s top hospitals for this procedure.

UT Southwestern Medical Center’s Department of Cardiovascular and Thoracic Surgery is among a distinguished group of U.S. centers that offers transcatheter aortic valve replacement (TAVR), a pioneering minimally invasive treatment for patients with severe aortic stenosis.

What Is Transcatheter Aortic Valve Replacement?

Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure for patients with severe symptomatic aortic stenosis, a narrowing of the heart's aortic valve that obstructs blood flow to the body. People with severe aortic stenosis suffer from reduced oxygen flow to the body and poor quality of life.

An alternative to open-heart aortic valve replacement, TAVR is performed by using a catheter, usually inserted through the groin, to replace the aortic valve. Patients can be back on their feet and enjoying life just a few days after the procedure.

UT Southwestern is one of only a few U.S. centers that offer high-risk and complex TAVR procedures.

While we offer traditional aortic valve replacement for people who are not candidates for less invasive procedures like TAVR, we strive to perform minimally invasive surgeries whenever possible. In most cases, our heart specialists can replace damaged aortic valves without open surgery, which significantly reduces patients’ pain and recovery time.

UT Southwestern also offers a dedicated Cardiac Rehabilitation Program. Cardiac rehabilitation is a critical component of recovery and can prevent future heart disease.

How Are Patients Evaluated for Transcatheter Aortic Valve Replacement?

Our heart valve experts, interventional cardiologists, and cardiothoracic surgeons carefully evaluate all patients to determine the most appropriate treatments for each person’s unique medical condition, preferences, and health goals.

Patients who meet TAVR criteria typically have factors that include:

• Severe aortic stenosis
• Shortness of breath (dyspnea) or heart failure
• Angina (chest pain originating in the heart)
• Syncope (fainting) or pre-syncope
• High risk of mortality or morbidity with traditional surgical valve replacement because of:
  • Advanced age
  • Prior cardiac surgery
  • History of kidney impairment
  • Prior stroke or carotid stenosis
  • Reduced ejection fraction

After an evaluation by our heart team, we’ll recommend the best treatment (surgical or transcatheter) for each individual patient.

What Should Patients Expect During Transcatheter Aortic Valve Replacement?

The surgeon provides specific instructions to the patient before the TAVR procedure, including risks such as bleeding, infection, or adverse reaction to anesthesia.

Patients also meet with the anesthesiologist prior to the surgery to review their medical history. TAVR can be performed with the patient completely asleep or under moderate sedation, depending on the patient’s other illnesses and preferences. Patients should not eat after midnight the night before the surgery.

On the day of surgery, the patient arrives at the hospital, registers, and changes into a hospital gown. A nurse reviews the patient’s charts to make sure there are no problems.

After surgery, patients are taken to the intensive care unit and monitored. Pain is likely, and pain medication is given as appropriate. Patients might also be on a respirator for up to a day after the surgery.

The length of the hospital stay depends on how quickly the patient is able to recover and perform some physical activity.

What Clinical Trials Are Available for Transcatheter Aortic Valve Replacement?

As one of the nation’s top academic medical centers, UT Southwestern offers a number of clinical trials aimed at improving the outcomes of patients with cardiovascular disease.

For example, clinical trials are currently ongoing in moderate-risk patients.

Clinical trials often give patients access to leading-edge treatments that are not yet widely available. Eligible patients who choose to participate in one of UT Southwestern’s clinical trials can receive treatments years before they are available to the public.