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Transcatheter Aortic Valve Replacement

Innovative Heart Care Procedure, Close to Home

If you’ve been diagnosed with aortic stenosis, but are considered an intermediate or high risk for surgery, transcatheter aortic valve replacement (TAVR) may be the solution you need to greatly improve your condition and quality of life. At Saint Vincent Hospital, our multidisciplinary team is able to offer this lifesaving procedure to otherwise inoperable patients in our state-of-the-art hybrid catheterization room.

One of the features that makes our TAVR program unique is the ability to perform the procedure under moderate sedation rather than general anesthesia. This approach lessens the risk associated with anesthesia.

What is TAVR?

TAVR is a newly developed procedure used to treat aortic stenosis, a condition that occurs when the one-way valve between the pumping chamber of the heart and the aorta becomes thickened and calcified, not opening well. In less serious cases, patients are able to undergo valve replacement surgery to help the condition. For patients with severe valve narrowing and older adults, the surgery risk may be too high. That’s where TAVR comes in.

Over the last few years, TAVR has been developed to provide a minimally invasive solution for high-risk patients. During this procedure, a new valve is placed through the blood stream, and a new valve is expanded within the patient’s own diseased valve. Usually this procedure is done the femoral (groin) blood vessels, but if you have extensive blood vessel disease, it may need to be done through an incision in the chest to place the new valve directly through the heart muscle.

Am I a Candidate?

TAVR is only for patients who are at high or intermediate risk for surgery and for those who are unable to have surgery. This procedure is only for aortic stenosis, not aortic regurgitation, as the calcification of the diseased valve is used to keep the new valve in place. TAVR requires that the diseased valve have three leaflets, not congenitally abnormal bicuspid (two leaflet) valves. TAVR is not approved for low-risk patients at this time. Surgical valve replacement is currently offered to patients considered to be at low risk because of the excellent long-term benefits of surgery.

TAVR Process: What to Expect

If your doctor suspects that you have severe aortic stenosis, especially if you are symptomatic, an echocardiogram is usually performed.  A referral to our Advanced Structural and Valvular Heart Disease program can provide you with an evaluation by our TAVR cardiologists and cardiothoracic surgeons.

We’ll review the outside echocardiogram or obtain one at Saint Vincent Hospital. If our team believes that your surgical risk is high and you might do better with a TAVR procedure, additional testing, including a specialized computed tomographic angiogram and cardiac catheterization, will be performed. Once additional testing has been completed, a follow-up evaluation will occur to review the testing results and discuss TAVR procedure options.

Preparing for the Procedure

The procedure is usually performed under general anesthesia under the supervision of a cardiac anesthesiologist. During preadmission testing, you’ll meet with an anesthesiologist who will also review your history, medications and lab tests. Some patients require admission the day before the procedure and others may be admitted the morning of the procedure. Instructions on preparing and arriving for your procedure will be given to you in advance.

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Sleeping Less Than Six Hours a Night Can Contribute to Heart Disease

Lack of sleep or short duration sleep, sleep apnea and other sleep problems have been associated with increased cardiovascular disease. According to a study from the National Institute of Health, those sleeping less than six hours per night were 66% more likely to have hypertension than individuals who got seven to eight hours per night. The American Heart Association recommends seven to nine hours of sleep; variance in this sleep pattern has been linked with obesity, high blood pressure and coronary artery disease.

11 Tips for a Good Night’s Sleep

  1. Don’t drink or eat caffeine less than 3 hours before bedtime
  2. Turn off screens (phones, laptop, TV, and other electronics) at least an hour before you want to fall asleep
  3. Dim lights and limit noise, unless it’s soft instrumental music, or sleep-inducing sounds
  4. Have some chamomile herbal tea (non-caffeinated)
  5. Finish exercising at least three hours before bedtime
  6. Don’t take a nap in the afternoon
  7. Avoid alcohol before bed – it can actually deplete you of deep, REM sleep
  8. Keep your room cool (but not too cold)
  9. Stay on schedule – go to bed and wake up at the same time each day to avoid difficult adjustments in sleep patterns
  10. Take a warm bath before bed
  11. If you’re still feeling restless, get up and do something relaxing, such as reading, until you feel sleepy.

If you frequently experience trouble sleeping, see a doctor. It may be something that can easily be addressed. A rested body is a healthier, higher functioning one, so make it a priority for healthy living.