Why is this procedure done?
The heart is a muscle that pumps blood through the body. The blood is pumped through the heart and body in one direction. Blood with oxygen moves away from the heart. Blood without oxygen moves toward the heart. The heart has 4 chambers which are separated by valves. The valves make sure that blood flows in the right direction. The aortic valve helps control the flow of blood away from the heart. ‚
Sometimes you were born with a heart valve that did not work the right way. Other times your heart valve has become damaged as you have gotten older. The blood may: ‚
- Flow backward through the damaged valve. This is aortic regurgitation.
- Have problems moving through narrow valve. This is aortic stenosis.
If you have valve problems, you may have chest pain or dizziness and problems breathing. You may notice these signs more when you are doing heavy exercise. ‚
You may need to have heart surgery to replace your damaged aortic valve with a new valve. This is an aortic valve replacement. There are different ways to do this surgery and different kinds of valves are used. Your doctor will decide the best plan of care for you. ‚
Your doctor may suggest a transcatheter repair if you are not able to have one of the other kinds of surgery because you are very sick, older, or have other problems with your heart. A catheter is put in through your upper leg. The catheter is moved into the valve to stretch it open. A new valve is placed in the space and begins to work to improve blood flow. ‚
What will the results be?
Your aortic valve will be replaced with one that works properly. The flow of blood through the heart should return to normal. ‚
What happens before the procedure?
- Your doctor will take your history. Talk to the doctor about:
- All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
- Any bleeding problems. Be sure to tell the doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin, ibuprofen, Aleve (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
- If you have an illness like a cold or sore throat. This may raise the risk of infection.
- When you need to stop eating or drinking before the procedure.
- Your doctor will do an exam and may order:
- A recording of your heartbeats. This is an ECG or EKG.
- A test that uses sound waves to make a moving picture of your heart. This is an echocardiogram, Echo, 2-D Echo, or ultrasound of the heart.
- Lab tests
- A chest x-ray.
- You will be asked to sign a consent form before the surgery. You will be told about other options as well as any risks and possible problems. Make sure you ask questions if you do not understand what will occur.
- You may be asked to take a bath with a special soap. This will help prevent infections.
What happens during the procedure?
- Once you are in the operating room, the staff will put an I.V. in your arm to give you fluids and drugs. You will be given a drug to make you sleepy. It will also help you stay pain free during the surgery.
- When you are asleep, the doctors put a tube in your mouth to help you breathe. Your doctor will put a tube in your bladder to drain urine.
- Monitors will keep track of your blood pressure, breathing, and heart rate.
- Your doctor will make a small cut on the skin of the upper leg. A small flexible tube called a catheter is put through the cut. It is moved through the blood vessels until it reaches the damaged aortic valve. The doctor uses special tools to watch where the catheter is going. This way the doctor can see the heart structures and the blood flow during the procedure. A new valve is wedged into the old valve. The new valve is expanded and it takes over making sure your blood only flows in one direction.
- Then, the doctor will secure the device and pull out the catheter. The cut site is closed and covered with a bandage.
- The procedure takes about 1 to 3 hours.
What happens after the procedure?
- You will go to the Intensive Care Unit (ICU) after surgery. The staff will watch you very closely. They will also give you drugs for pain through the I.V. as needed.
- You will move to a regular hospital room when stable.
- You will stay in the hospital for about 3 to 5 days after surgery.
- The device placed inside of your heart will be covered with new tissue over time.
What drugs may be needed?
The doctor may order drugs to: ‚
- Help with pain
- Prevent infection
- Prevent blood clots
What problems could happen?
- Bleeding
- The catheter may cut into a blood vessel
- Fluid around the heart
- Infection
- Blood clots
- New heart valve may fail
Helpful tips
Talk to your dentist about the aortic valve repair. You may need to take drugs to prevent infection before going to the dentist. This is most often needed only during the first 6 months after surgery. ‚
Where can I learn more?
American Heart Association ‚
http://www.heart.org/HEARTORG/Conditions/More/HeartValveProblemsandDisease/What-is-TAVR_UCM_450827_Article.jsp ‚
National Heart Lung and Blood Institute ‚
http://www.nhlbi.nih.gov/health/health-topics/topics/hvd/treatment.html ‚
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
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Copyright ‚ © 2015 Clinical Drug Information, LLC and Lexi-Comp, Inc. ‚