What Is Transcatheter Aortic Valve Replacement?

The heart is a four-chambered organ that pumps blood to the lungs and throughout the body that normally includes four working valves: the aortic, mitral, pulmonic, and tricuspid valves. These typically allow blood to flow from one chamber to another and are usually controlled by pressure and muscle movements. If any of the heart’s valves become diseased or are damaged, the consequences can be fatal and major surgery is generally required. One procedure that can be performed is transcatheter aortic valve replacement, in which a replacement valve is folded up, passed through an artery into the heart, and expanded in place.

Instruments called stents are often passed into arteries and expanded with balloons. These have generally been used to open clogged arteries or ones that have narrowed with age or disease. In a transcatheter aortic valve replacement, the heart valve is placed inside a metal scaffolding, called a stent. The assembly is normally then incorporated into a catheter, which is inserted into the femoral artery in the leg or into an artery through a chest incision.

A metal stent can be opened by a surgeon when the device is positioned within the old aortic valve. Special x-ray machines are often used for physicians to see where the device is. When the stent opens, the device is typically anchored in place without stitches. There is generally no need for bypass surgery or any other kind of open heart procedures. Research has shown that recovery from transcatheter aortic valve replacement is usually faster than with more invasive procedures.

Patients who undergo transcatheter aortic valve replacement sometimes experience heart attacks, or strokes, while a few need a pacemaker after the surgery. Many people with serious heart conditions survive for longer with the implanted valve. Studies as of 2011 continue to evaluate the valve replacement complications following the procedure and how they can be minimized. The people that qualify for the procedure often have advanced heart disease and are not well enough to undergo traditional surgery.

When the aortic valve becomes narrower than it should be, this can prevent an adequate supply of blood from flowing. Valve replacement is usually the only long-term solution that can improve one’s chances of survival. Multiple diseases of the valve, blood disorders, and other serious life-threatening conditions can disqualify someone from receiving a transcatheter aortic valve replacement. A patient’s health is usually evaluated by surgeons and other specialists before the operation is performed.