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Having a Transcatheter Aortic Valve Replacement

Your healthcare provider recommends that you have a transcatheter aortic heart valve replacement (TAVR). This is a surgery to implant a new tissue or biological valve inside of the diseased aortic valve. TAVR is done by putting a thin, flexible tube called a catheter through a blood vessel (artery) in your groin. It can also be done through a small incision under the collarbone, or between your ribs. The catheter is used to deliver an artificial valve to your heart. The TAVR procedure has been recommended to you as an alternative to open heart surgery.

Talk with your healthcare provider about any questions or concerns you have before the surgery. The surgery takes 3 to 5 hours. You’ll typically stay in the hospital for 1 to 3 days. Here’s what to expect before, during, and after the procedure.

Before the procedure

Before the day of surgery, you will have a physical exam and tests. These tests include X-rays, CT scans, lung tests, and blood tests. You will have an echocardiogram to check your aortic valve. This is a test that uses sound waves to create images of your heart. You may also have a cardiac catheterization. This will tell your healthcare provider more about your heart and how blood is flowing through your arteries and about the pressures inside your heart and lungs.

Before the surgery you will also need to do the following:

  • Tell your healthcare provider about all medicines you take. This includes over-the-counter medicines, vitamins, herbs, and other supplements. It also includes any blood thinners, such as warfarin or daily aspirin. You may need to stop taking some or all of them before your surgery.

  • Tell your healthcare provider if you’re allergic to any medicines, have had a reaction to anesthesia, or have a bleeding disorder.

  • Stop smoking. Ask your healthcare provider how soon before surgery you need to quit.

  • Stop eating or drinking for a certain number of hours before the surgery. Your healthcare provider will give you specific instructions.

  • Shower with special soap before the surgery if advised.

  • Follow all other instructions that you are given.

During the procedure

The TAVR procedure uses a less invasive approach than traditional aortic valve replacement surgery. The procedure is generally done while you are under conscious sedation in an operating room or specially equipped catheterization lab. This means that you will be awake but sleepy and comfortable during the procedure.

  • An IV line is put in your arm or hand. This gives you fluids and medicine. To keep you free of pain during the surgery, you are given conscious sedation. A monitor called an arterial line is put into the artery in your wrist to monitor blood pressure and take blood samples.

  • Rarely, a small probe is placed into your throat. This is to do echocardiograms during the procedure. If this is done, you will be placed under a deeper level of sedation.

  • Antibiotics are given before the procedure to protect you from infection. You will also get antibiotics after the procedure.

  • A catheter is put in the femoral artery in the groin. It is then guided through the artery up into your heart and to your aortic valve. Other catheters, from the neck, wrist, or the other leg, may be put in your heart to take measurements and X-ray pictures during the procedure.

  • The new valve is placed through the catheter to the heart.

  • When the balloon is in the right place in the aortic valve area, it will be either inflated  or allowed to expand into position, depending on the type of valve. This puts the new valve in place.

  • Measurements and images are taken to make sure your new valve works properly. Then the catheters are removed.

  • The catheter in your leg is removed and your incision is closed.

If your groin artery is too small, the catheter may be put through a cut under the collarbone or between your ribs instead.

After the procedure

You’ll be moved to the intensive care unit (ICU) to start your recovery. When you first wake up, you may feel groggy, thirsty, or cold. These feelings won’t last long. You will likely have some thin tubes in your body. These are to give you medicines and nutrition, and to measure your heart function. If you had the surgery done through your ribs, you may also have a drainage tube coming out of your chest. The tubes will be removed when they are no longer needed. Medical staff members will carefully watch you. You may have a breathing tube in your throat after the procedure, although this is rare. It is usually removed when you are able to wake up. When your condition is stable, you’ll be taken to your hospital room.

Your recovery will depend on how invasive your procedure is for your valve replacement. You will likely need to stay in the hospital for several days. You may even need to stay longer than a week depending on the situation. If you’ve had the surgery done through your ribs, you may spend more time in the hospital than if you had the surgery done through your groin. After you leave the ICU, you will go to a general cardiology area of the hospital to finish your recovery. You’ll be encouraged to stand and walk, even if you feel tired. Walking helps your muscle strength, blood flow, and breathing. Your healthcare provider will let you know when you can go home. Have a family member or friend drive you home.

Author: StayWell Custom Communications
Last Annual Review Date: 1/1/2018
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