Transcatheter Aortic Valve Replacement (TAVR)

A Minimally Invasive Procedure for Aortic Stenosis

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Overview

Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure that treats aortic stenosis, a narrowing or thickening of the aortic valve, by inserting a new valve in the diseased aortic valve. TAVR is an alternative to open-heart aortic valve surgery. It can increase blood flow to the heart and improve symptoms like chest pain, shortness of breath, and fatigue. Duke cardiologists and heart surgeons perform TAVR procedures in people with severe aortic stenosis, including those who have been told they are at high risk or not candidates for traditional aortic valve replacement surgery.

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Is TAVR Heart Surgery?

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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.

TAVR Benefits and Complications

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Compared with traditional aortic valve replacement surgery, TAVR carries a lower risk of bleeding, shortens recovery, and reduces hospital stays.

Because any aortic valve surgery or procedure can trigger heart conduction problems, some people undergoing TAVR need to have a pacemaker implanted afterward.

Serious complications from TAVR are rare. The most common possible complications include damage or bleeding at the incision site, coronary artery obstruction caused by the replacement valve displacing the old valve and blocking blood flow to the heart, kidney or heart injury, valve leakage, heart rhythm problems, and stroke.

Our Locations

TAVR procedures are performed at Duke University Hospital. Pre- and post-operative appointments are available in Durham.

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TAVR Evaluation and Testing

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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 if you are a candidate for TAVR:

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

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What to Expect

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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.

Best Heart Hospital in North Carolina

When it comes to your heart care, you want the very best. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our cardiology and heart surgery program is nationally ranked, and the highest ranked program in North Carolina, according to U.S. News & World Report for 2022–2023.

Why Choose Duke

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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 nearly 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.

Related Conditions

Aortic Valve Disease

This page was medically reviewed on 02/28/2023 by

Adam Williams, MD | Heart Surgeon