Aortic stenosis is the narrowing and restriction of the opening of the aortic valve. The aortic valve connects the major pumping chamber of the heart to the artery connecting to the rest of the body. Causes include age related calcium deposits, rheumatic fever and birth defects. Symptoms include shortness of breath, feeling tired with little activity, chest discomfort, feeling like you might pass out and swelling in your feet, ankles or legs.

TAVR (Transcatheter Aortic Valve Replacement) is a procedure to place a new aortic valve inside of your stenotic valve using catheters instead of a traditional open heart surgery. This procedure requires an evaluation from a heart valve team.

Is TAVR the Right Plan of Care For You?

We aren’t sure yet. The heart valve team needs a lot of information about you, your heart, and your general health before we can make that decision. You will have several appointments and tests during this process. After testing, our team will then discuss your case at our heart valve team conference and formulate a plan for you.

What Happens Before Your TAVR Procedure?

There will be several things needing to be done prior to your procedure. This includes appointments, testing, and a heart valve team conference. After your case is discussed, you will receive a phone call from the valve coordinator giving you our recommendation. If TAVR is the right plan for you then we will review pre-TAVR instructions. If you were to have any questions or concerns during this process, please call 334-712-3315.

Cardiac Echocardiogram (ECHO)
This is an ultrasound of the heart that will give us information about your heart valves and how well your heart is functioning. This test is painless and is done while you’re awake. It takes roughly 30-60 minutes. Even if you have recently had an ECHO, the heart valve team may want a new one done at this time.

Computed Tomography (CT Scan)
This is a test that uses x-rays and computers to give us information about your heat and blood vessels in your groin for possible access for the procedure. The test is painless and takes about 30 minutes. You will have to have an intravenous line (IV) placed in your arm to give you a special dye needed for the test. Do not eat or drink anything after midnight before the test.

Coronary Angiogram (Heart Cath)
This procedure is done by a cardiologist where they will place an IV in your groin or wrist and use catheters, x-ray, and contrast dye to get information about your heart and the blood vessels in your heart. They may also measure pressures inside of your heart chambers. You will be given some medication to relax but still remain awake and will have to remain in the hospital for 4-6 hours after the procedure. Specific instructions will be given to you prior to this procedure.

Pulmonary Function Tests (PFT’s)
This is a test used to determine how well your lungs are working. The test measures lung volumes, capacity, rates of flow, and gas exchange inside the lungs. This is a non-invasive test and only requires several breathing exercises. Do not take any breathing medications the day of the procedure.

Carotid Ultrasound
This is a non-invasive ultrasound test that uses high-frequency sound waves to create pictures of the inside of your carotid arteries in the neck that carries blood from your heart to your brain. The test is used to see if there is any blockage in these arteries.

Atrial Fibrillation, known as AFIB or AF, is an irregular heartbeat or arrhythmia that can result in a stroke as well as other heart-related problems. AFIB causes the upper chamber of the heart to beat irregularly rather than beating effectively to move blood into the ventricles.

If you have AFIB then you have risk of stroke five times greater than someone with a regular heartbeat. Chances are that to manage that risk, you’re taking a blood thinner like warfarin, which can come with risks of its own.

There is help for patients with AFIB not caused by a heart valve problem. WATCHMAN is a permanent implant, about the size of a quarter that closes off a part of the heart where blood clots commonly form. It does not require open heart surgery, and in most cases the patient will go home the next day.

Research shows that many people are able to stop taking warfarin as soon as 45 days after the procedure. In one study, 99 out of 100 people were able to stop taking warfarin by the end of the first year.