Transcatheter Aortic Valve Replacement (TAVR)

TAVR, also known as transcatheter implantation (TAVI), is a much less-invasive approach to aortic valve replacement surgery. The procedure takes place in a hybrid operating room, which combines elements from both a catheterization laboratory and a traditional operating room. Advanced imaging provides a real-time view of your blood vessels as your doctor makes an incision -- either in the groin, neck, or the upper chest -- and threads a catheter through a vessel to reach the diseased aortic valve. (The best approach is determined by your doctor, and is based on your anatomy and overall condition.) A new valve made of animal tissue is expanded inside your original aortic valve, restoring blood flow and relieving the obstruction from aortic stenosis. 

Watch this video to see how the TAVR procedure works. 

You may be a candidate for TAVR if you have:

• Severe aortic stenosis 
• Medical conditions that increase your risks with traditional open-heart surgery
• Had a previous aortic valve replacement or heart bypass surgery

Your doctor may recommend one or more of the following tests to identify and evaluate the severity of your aortic valve disease and determine whether you are a candidate for TAVR:

• Electrocardiogram (ECG) 
• Echocardiogram and/or 3D transesophageal echocardiogram
• CT angiogram
• Cardiac MRI
• Cardiac catheterization

Before TAVR
Your doctor may tell you to stop taking certain medications before a TAVR procedure. Through an IV placed in your arm, you will receive a sedative to help you relax and other medications to reduce the risk of infection or blood clots. TAVR does not require general anesthesia.

During TAVR
On average, a TAVR procedure takes one or two hours (compared to much longer surgical times for traditional aortic valve replacement surgery).

After TAVR
You will need to stay in the hospital at least overnight. Some people need to stay for a few days, depending on factors like whether you need a pacemaker. You should be able to return to normal activities after a few weeks.

About a month after TAVR, you’ll see your doctor to check on your new valve. You may need yearly follow-up visits to make sure the valve continues to work well.

Experience and Expertise
Our early involvement in the development of TAVR through clinical trials means we have extensive experience with this procedure. Duke's structural heart specialists and heart surgeons have performed more than 2,000 TAVR procedures since 2012. Research shows that hospitals and surgeons who perform more surgeries tend to have better outcomes.

A Team of Aortic Valve Replacement Specialists
A specially trained team of interventional cardiologists, surgeons, anesthesiologists, radiologists, and other experts is involved in every TAVR procedure we perform. Together, the team reviews each patient’s unique needs and determines the best treatment plan.

More Options for TAVR Procedures
Our specialists work with all commercially available TAVR devices and are skilled in multiple delivery approaches. This allows us to provide customized care to meet your individual needs. 

High-Speed Imaging
Your heart is constantly in motion, making it challenging to get a still image. High-speed cardiac imaging capabilities allow us to get a clear picture of your heart, which helps us determine the right device, the right approach, and the right treatment plan for you.