Who is it for?
There are essentially three treatment options for aortic valve stenosis (narrowing of the aortic valve): surgical aortic valve replacement (SAVR), transcatheter aortic valve replacement (TAVR), or medical therapy. The best treatment for you depends on how severe your condition is and what other medical conditions you might have. Your heart team, which includes cardiologists and heart surgeons, will consider these factors and will order several tests, including an ultrasound of the heart or an echocardiogram (echo), a cardiac computerize tomography (CT) scan, and a cardiac catheterization. Based on your medical history, physical exam, and the test findings, your heart team will make a determination as to whether you’re an appropriate candidate for TAVR.
In patients at high risk for surgical complications, TAVR is the best option. In low- or intermediate-risk surgical patients, TAVR and surgery both have pros and cons. In general, TAVR recovery is easier and the risk of up-front complications is lower. With surgery, there's more research related to the long-term durability and performance of the valve. TAVR valves have shown equivalent outcomes to surgical valves up to six years. Studies are ongoing to understand longer-term results of TAVR versus SAVR. There's a large amount of research on the longevity of tissue surgical valves, with most studies showing a lifespan of 15–20 years. A “heart team” composed of an interventional cardiologist (who typically performs TAVR) and a cardiac surgeon (who performs SAVR) will review your case together and help you decide the best treatment option for you.
It may be variable between hospitals, but most patients can go home as soon as the next day after the procedure. With TAVR, there’s no “recovery period” unlike SAVR, which requires a longer hospital stay and a longer recovery period that may take months. With TAVR, you can go back to doing what you were doing the day before the procedure, with no limitations apart from avoiding heavy lifting for several days.
In some patients, medical therapy may be the only option. While medications won’t “cure” your aortic valve stenosis, it can be used to reduce your symptoms and the risk of certain complications. Even if you undergo TAVR or SAVR, you’ll likely also be given medications to treat your high blood pressure, which is seen in a majority of patients with aortic valve stenosis.