TAVR - Transcatheter Aortic Valve Replacement

Changing the Face of Treatment for Patients with Aortic Stenosis

What is Aortic Stenosis?

Aortic stenosis is a progressive disease that occurs with a narrowing of the patient’s aortic valve opening due to a buildup of calcium deposits on the valve leaflets. When the valve fails to open fully, the valve opening narrows thereby obstructing blood flow out of the heart. Over time, the leaflets become stiff, reducing their ability to fully open and close. When the leaflets don't fully open, a person's heart must work harder to push blood through the aortic valve to the rest of the body. Eventually, the heart gets weaker, increasing the risk of heart failure.

Aortic stenosis primarily happens over time as we age but can also be caused by a birth defect, previous chest radiation, or rheumatic fever. The prevalence of aortic stenosis increases with age. It is estimated that approximately 2.5 million people, or 12.4% of the population, in the United States over the age of 75 suffer from aortic stenosis.

Overview of Aortic Stenosis

Human heart valves are remarkable structures. Normal heart valves have two or three flaps of tissue called leaflets. These tissue-paper thin membranes attached to the heart wall constantly open and close to regulate blood flow (making the sound of a heartbeat).

In elderly patients, aortic stenosis is sometimes caused by the buildup of calcium (mineral deposits) on the aortic valve’s leaflets. Over time, the leaflets become stiff, reducing their ability to fully open and close. When the leaflets don’t fully open, a person’s heart must work harder to push blood through the aortic valve to the rest of the body. Eventually, the heart gets weaker, increasing the risk of heart failure (when the heart cannot supply enough blood to the body).

Severe Aortic Stenosis

Aortic stenosis is a progressive disease which means it gets worse over time. It’s typically measured as mild, moderate, or severe aortic stenosis. As a result of the reduced blood flow, the body does not get the oxygen it needs, which may cause symptoms. If a patient has been diagnosed with severe aortic stenosis and is experiencing symptoms, it can be life-threatening and may progress rapidly.

However, it’s important to know that heart valve disease may occur with no outward symptoms. Many patients initially appear asymptomatic, but on closer examination, up to 32% exhibit symptoms. The symptoms listed below are typically associated with severe aortic stenosis but are commonly misunderstood by patients as “normal” signs of aging.

Symptoms of Severe Aortic Stenosis

You may notice symptoms like:

• Shortness of breath
• Fatigue/significant decline in energy levels
• Lightheadedness, feeling dizzy
• Fainting, passing out
• Chest pain

Major Risk Factors

Factors associated with aortic valve disease include the following:

• Increasing age
• High blood pressure
• High cholesterol
• Smoking

Diagnosis

In addition to a physical exam, severe aortic stenosis is diagnosed in several ways, the most common being an echocardiogram and/or cardiac catheterization (angiography). As part of your evaluation for valve replacement, you can also get an electrocardiogram (EKG), chest X-ray, or CT Scan.

What is Transcatheter Aortic Valve Replacement (TAVR)?

TAVR is a less invasive procedure than open-heart surgery which allows a new valve to be inserted within the native, diseased aortic valve. The TAVR procedure can be performed using one of many approaches, the most common being the transfemoral approach (through an artery in your groin). The BHS Heart Team will decide which approach is best, based on your medical condition and other factors.

To find out if you are a candidate for TAVR, make an appointment with the BHS Valve Clinic by calling 724-284-4026.