Transcatheter Aortic Valve Replacement (TAVR)

Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure to replace the aortic valve of the heart for high-risk patients with severe aortic valve stenosis who are not candidates for traditional open heart surgery. TAVR is performed on a beating heart and does not require a large surgical incision or the support of a heart-lung machine.

At the Brigham and Women's Hospital (BWH) Heart & Vascular Center, one of the nation's most experienced centers in transcatheter valve replacement, cardiac surgeons and interventional cardiologists work alongside imaging specialists and anesthesiologists to perform this advanced technique. Brigham and Women's Hospital was one of two hospitals in New England and one of 24 nationwide to examine the benefits of TAVR as part of the PARTNER (Placement of AoRTic TranscathetERValve) clinical trial. TAVR was approved by the FDA in 2011. Brigham and Women's Hospital successfully completed its first TAVR procedure in 2009 and has performed over 500 since then.

This deep experience and their collaboration with a multidisciplinary team of cardiac specialists through the Interventional Cardiology Program enables our cardiac surgeons to handle the most complicated cases, with a range of treatment options that improve the lives of patients experiencing aortic stenosis.

With 47,000 outpatient visits each year, the Heart & Vascular Center is one of the largest in the United States, treating over 7,000 inpatients and performing more than 8,000 procedures annually at our state-of-the-art Shapiro Cardiovascular Center.

Transcatheter Aortic Valve Replacement (TAVR) Topics

Transcatheter Aortic Valve Replacement (TAVR) Procedure

During transcatheter aortic valve replacement, a cardiac surgeon and interventional cardiologist use imaging equipment to evaluate the arteries. Your cardiac specialist then decides which entry point on the body is the best and safest way to access the aortic valve.

A catheter with a stented valve on the end is guided into the heart through a small incision in one of the following locations:

  • Upper leg or groin (transfemoral approach)
  • Upper Chest (transaortic approach)
  • Chest between the ribs (transapical approach)

The valve is then deployed. The catheter is then removed. Imaging equipment helps confirm that the new valve is working properly before the catheter is removed and the access sites are closed.

Because TAVR is a minimally invasive technique, patients experience a quicker recovery than they would from a traditional, open-heart valve replacement. The entire procedure, performed under local and/or general anesthesia, takes 90 minutes while open heart surgery typically takes four to six hours, followed by a two to three month recovery period. With TAVR, patients resume daily living quickly with a high quality of life.

Why Have Transcatheter Aortic Valve Replacement?

Transcatheter aortic valve replacement is a relatively new procedure reserved for people who:

  • Are not candidates for open heart surgery
  • Have medical conditions that make open heart surgery impossible or excessively risky
  • Have severe aortic valve stenosis

Learn more about aortic valve repair and replacement options.

What You Should Expect

The Heart & Vascular Center is located in the Shapiro Cardiovascular Center, across the street from BWH's main 75 Francis Street entrance. The Heart & Vascular Center brings together the full range of services in one location, fostering seamless and coordinated care for all cardiovascular patients.

Prior to surgery, you will be scheduled for a visit to the Watkins Clinic in the Shapiro Cardiovascular Center for preoperative information and tests.

The day of surgery, your care will be provided by surgeons, anesthesiologists and nurses who specialize in aortic valve disease. The Heart & Vascular Center is home to one of the most advanced hybrid operating rooms in the country. After surgery, you will recover in the post-surgical care unit where you will receive comprehensive care by an experienced surgical and nursing staff.

During your surgery, family and friends can wait in the Shapiro Family Center where staff members will provide surgery updates.

Multidisciplinary Care

In addition to our cardiac surgeons and interventional cardiologists, patients also benefit from the teamwork of medical cardiologists, cardiovascular imaging experts and radiologists, and anesthesiologists, all experts in cardiovascular disease. They work alongside nurses, physician assistants, physical therapists, dietitians and social workers to achieve outstanding outcomes for our patients.

Resources

Learn more about heart valve repair and replacement surgery in our health library.

Visit the Kessler Health Education Library in the Bretholtz Center for Patients and Families.

Access a complete directory of patient and family services.

Learn about the Watkins Clinic in the Shapiro Center.

Download Cardiac Surgery: A Guide for Patients in English or Spanish.

LEARN MORE ABOUT BRIGHAM AND WOMEN’S HOSPITAL


For over a century, a leader in patient care, medical education and research, with expertise in virtually every specialty of medicine and surgery.

About BWH