8 Things to Know About TAVR, a Less Invasive Way to Replace an Aortic Valve – Yale Medicine

[Originally published: July 22, 2020. Updated: Dec. 14, 2023.]

TAVR, or transcatheter aortic valve replacement, is a potentially lifesaving procedure used to treat a heart condition called aortic stenosisa narrowing of the aortic valve. The development of significant aortic stenosis becomes more common as people age and can increase strain on the heart, eventually leading to heart failure.

For patients undergoing TAVR, a catheter is placed through a blood vessel in the legthrough this catheter, a new valve is delivered to the heart, replacing the failing aortic valve. Patients undergoing the procedure require minimal sedation, are up and walking the same day of the procedure, and usually go home the next day. Thats very different from open-heart surgery, long considered the gold standard treatment for aortic stenosis.

Yale performed the first TAVR in Connecticut in July of 2011, says Yale Medicine cardiologist John K. Forrest, MD. At that time, TAVR was limited to patients considered high risk for open-heart surgery. Given the benefits of TAVR, including a faster recovery and quicker improvement in quality of life compared to surgery, there was an incentive to evaluate this technology in lower-risk patients. In 2019, due in part to studies led by Yale physicians, TAVR approval was expanded by the Food and Drug Administration (FDA) to include all patients with severe aortic stenosis regardless of their surgical risk.

In the last few years, the number of aortic valve procedures done with a transcatheter approach has surpassed the number done with open-heart surgery," says Dr. Forrest, director of the Structural Heart and Valve Disease Program and the Interventional Cardiology Program at Yale.

As of November 2023, more than 2,500 patients have had TAVR in the Yale New Haven Health System hospitals in New Haven and Bridgeport, Connecticut. There are plans for Yale physicians to provide the procedure at the Veterans Affairs (VA) Connecticut Healthcare System in West Haven, making it one of the first VA hospitals in the Northeast to provide TAVR.

Many patients still undergo open-heart surgery, also called surgical aortic valve replacement (SAVR), often because their valve isnt anatomically suited to TAVR, and surgery remains an excellent option for some patients, Dr. Forrest adds. In fact, having two different treatment choices has led to a new approach to aortic stenosis in which a collaborative team of cardiac specialists helps each patient determine the best approach for them.

Below, Dr. Forrest and Yale Medicine interventional cardiologist Amit Vora, MD, MPH, answered common patient questions about TAVR.

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8 Things to Know About TAVR, a Less Invasive Way to Replace an Aortic Valve - Yale Medicine