How will you get the new valve to my heart?
How your doctor gets the valve catheter to your heart makes a difference in your recovery. Duke doctors strive to place the catheter through a blood vessel, most commonly in your groin (the “transfemoral approach”), rather than making an incision in your chest (“transapical access”). In transapical TAVR, the doctor usually makes an incision between the ribs in the left chest and puts the catheter directly through the heart muscle. Recovery following this procedure is more difficult, and survival rates are lower than for transfemoral TAVR. In 2017, 0 percent of Duke TAVR patients required chest incision*.
What valves do you have available? How will you decide which is best for me?
This is important because the approved TAVR valves don’t work for every patient. Centers that don’t have access to all available valves may not be able to treat everyone who can benefit. At Duke, we have access to and experience with all of the most current and advanced valves. Our team of heart surgeons, interventional cardiologists, and heart imaging experts meets weekly to review each patient, their test results, and their medical images in order to determine the best treatment option for each individual.
How long will I be in the hospital after my TAVR procedure?
Typically, Duke patients leave the hospital within two days following a TAVR procedure.
How will you coordinate my care?
We communicate with your primary care doctor before and after your procedure to ensure you have continuity of care. The majority of your medical care can be provided by your local doctor. If you’re coming to Duke from out of town, we can coordinate your appointments so you’ll have imaging, diagnostic tests, and doctor consultations all in one day. Typically, the process involves one or two visits before your procedure plus two follow-up visits -- one at two weeks after your procedure and one at the one-year point following your TAVR procedure.
* Source: STS/ACC TVT RegistryTM 2017 Q4 data. The registry is a collaboration between the Society of Thoracic Surgeons and the American College of Cardiology to monitor patient safety and outcomes in transcatheter heart valve procedures.