TAVR

Happy couple in the mountains Enloe Health is the leader of Transcatheter Aortic Valve Replacement (TAVR) procedures in the North State. This innovative and proven procedure is used to treat severe aortic stenosis or heart valves that are failing.

Using this minimally invasive approach, Enloe’s trusted structural heart specialist can replace deteriorating aortic valves and help improve your heart health.

If you’re in need of care, the team at Enloe Health Structural Heart & Valve Center will work with you to find the best treatment plan.

A Team Approach

TAVR teamOur experienced team includes a specialty trained interventional cardiologist, who has over 10 years of experience in TAVR procedures and works with our cardiothoracic surgeon. The team uses a minimalist TAVR approach, which:

  • Allows the use of conscious sedation instead of general anesthesia
  • Eliminates the need for open heart surgery
  • Results in shorter hospital stays
  • Facilitates faster recovery and early mobility
  • Improves outcomes
  • Increases patient satisfaction

When you see us at Enloe Health Structural Heart & Valve Center, you’ll work with our dedicated structural heart and valve coordinators, ensuring continuity of care.

TAVR Explained

Grandfather with childYour care team will recommend a TAVR procedure if your aortic valve is severely unhealthy and needs to be replaced. Having a TAVR procedure is less invasive than open-heart surgery. The most common approach involves making a small incision in the leg. This is called a transfemoral approach.

The entire procedure takes about 2 hours in total. However, the TAVR procedure itself usually takes 45 minutes to an hour, depending on your health and the approach. Your care team will determine the type of anesthesia that’s best for you. You will likely be asleep but breathing on your own and given medication to help you relax and block pain.

On the day of your TAVR procedure, if your care team opts for the transfemoral approach, a small incision will be made in your upper leg. Your doctor will insert a short, hollow tube called a sheath into your femoral artery. The new valve will be compressed, so it’s small enough to be placed on a delivery system. That system will be advanced to your heart across your aortic valve. Once it reaches your unhealthy valve, your old valve will be pushed aside as the new valve will be expanded into place. Your team will do an ultrasound of your heart to ensure the new valve is working properly before removing the delivery system. People usually stay in the hospital one or two days after this procedure.

At Enloe Health, TAVR procedures are usually done on Tuesdays. As your procedure approaches, a structural heart coordinator will contact you with a personalized and detailed plan for your upcoming procedure.

Older man with cardiologist Some people feel relief from their symptoms right after their TAVR. For others it takes longer. Research shows people who have this procedure have better heart function and a better quality of life in 30 days.

You will need to adjust your activities during recovery. Participating in Enloe Health Cardiac Rehabilitation can safely improve your recovery and help you increase your physical activity.

Aortic Regurgitation

Aortic Regurgitation Your heart valves work like doors within your heart. Normally, when a valve closes tightly, the chamber of your heart fills with blood, and when it opens, blood is released into the next section of your heart or out to the rest of your body by the aorta.

Aortic regurgitation, which is also called aortic insufficiency, can occur when the aortic valve does not close tightly enough. When this happens, some blood leaks back into the previous section of the heart. This condition is rated on a severity scale of trace, minimal, moderate or severe regurgitation.

Aortic regurgitation can happen for a variety of reasons. Regardless of its origin, there are symptoms associated with the condition that should be discussed with your cardiologist or health care provider. Those symptoms may include:

  • Shortness of breath when exercising or lying down
  • Palpitations (heart racing)
  • Swollen ankles or feet
  • Fainting
  • Chest pain
  • And heart failure

If you are diagnosed with moderate to severe aortic regurgitation, treatment options are available. Ask your provider for a referral to Enloe Health Structural Heart & Valve Center to discuss the right option for you.

Aortic Regurgitation Graphic Created by Eko Health, Inc.

Learn More

Watch this video to learn amore about the TAVR procedure.

Hear from a Patient

At 82 years old, James Nicholls was the 100th TAVR patient at Enloe Health. He was able to return home after just two days — and immediately noticed he was no longer short of breath and that his strength returned.

“I went to the doctor a week later and the nurse was flabbergasted,” Nicholls said. “She said she could hardly keep up with me. I would absolutely recommend them. I was so impressed ... and felt I was in very good hands.”

Read the Story

FAQs

I have aortic stenosis. What are my next steps?

Aortic stenosis is graded on a severity scale. It can be mild, moderate, severe and critical. Once an echocardiogram — also known as an ECHO — is done, the severity can be more accurately assessed. If you have mild or moderate aortic stenosis, it may take years or months to reach a severe state. This is why regular ECHO scans are important.

If you have severe or critical aortic stenosis, you will need more immediate care. Regardless of your severity, being aware of aortic stenosis and following up with a cardiologist regularly are important.

Enloe Health Structural Heart & Valve Center can help you monitor your aortic stenosis and determine if you’re a candidate for TAVR or if surgery is needed. Reach out to your primary care provider or cardiologist for a referral.

What can I expect at my first appointment?

A receptionist will greet you and a medical assistant will take you into one of our clinic rooms. This caregiver will take your vital signs and check your medications. Then an interventional cardiologist and a structural heart coordinator will see you.

You will be asked questions to assess your symptoms, and your team will go over your ECHO results. These caregivers will answer your questions and will decide which treatment would best suit you. They will also schedule any additional tests needed. You will be given a booklet that explains the TAVR procedure in detail, as well as contact information to reach the structural heart coordinator should any questions arise.

What other tests will be needed before the TAVR procedure?

You may need another ECHO, depending on your original ECHO. You will need a cardiac catheterization so your care team can see if there’s any narrowing in your coronary arteries. You will also need a CT scan to analyze the best way to deploy the TAVR valve and the valve size you will need.

If your cardiologist finds your procedure will require another route besides femoral access, the structural heart coordinator will call you and notify you of any additional tests needed.

When will I be scheduled for my TAVR?

Once the tests are completed and your results are reviewed, the structural heart coordinator will call you to schedule your procedure. Your procedure will usually be scheduled for the following week.

If any tests show that the TAVR procedure would not be the best option for you, the structural heart coordinator will call you to schedule a follow-up appointment with the cardiologist to discuss next steps.

What should I expect on the day of the TAVR?

The structural heart coordinator will give you a personalized plan for the day of and day before your procedure. On the day of your procedure, you will register at Enloe Health Enloe Medical Center. Be sure to bring your ID and insurance card.

You will then be taken to the preprocedural area where you will change into a gown and have an IV inserted into your arm. Your groin will be shaved, and an ECHO will be done. You will speak to an anesthesiologist, a cardiothoracic surgeon and an interventional cardiologist. Next, your care team will wheel you back into the catheterization room where you will be monitored with equipment to track your vital signs.

You will then be given IV medications to fall asleep while the procedure is performed. You will wake up in the post-procedure area and then taken to the second floor of the hospital to recover until you go home the next day.

Can I have family members with me during the procedure?

Your loved ones may accompany you into the hospital while you wait for your procedure. Once you are wheeled back for the procedure, your loved ones will be escorted into the waiting room. They will be escorted into your room after you wake up from the procedure.

Are there any restrictions immediately after the TAVR?

You must lie flat for 4 hours after the procedure. Then your bed will be elevated to 30 degrees for another 2 hours. After that, you are free to walk around with the help of your nurse or aide until the medications fully wear off.

Your nurse will frequently monitor your access sites for issues. Members of your heart care team will visit you the day after your procedure to go discuss your recovery. 

Will I be on blood thinners after the procedure?

Typically patients will be prescribed one or two blood thinners temporarily depending on their medical history. This is to ensure you don’t develop a blood clot on your new heart valve. Before you leave the hospital, your care team will discuss the medications that would be best for you and how long you will take them.

When do I follow up with my other doctors?

You should continue to see your primary care provider as usual. You will need to tell him or her you had a TAVR procedure and provide the caregiver with your TAVR valve card for your medical records. You should also keep regular appointments with your primary cardiologist. You will see your TAVR cardiologist one month and one year after your TAVR procedure.

What precautions do I need to take after getting a new TAVR valve?

Immediately after the TAVR procedure, your new valve is in place and already working as it should. For the next three to six months, your body will begin the natural process of covering this new valve in your own cells.

This process is called endothelialization. During this time, it’s important to avoid any procedures or surgeries, like routine teeth cleanings. After three to six months, it’s OK to have routine procedures done as long as you take an antibiotic beforehand. You will need to take an antibiotic before any procedure or surgery for the rest of your life. This can be prescribed by your primary care provider or cardiologist. After your procedure, your care team will tell you more about this. If you have questions, feel free to reach out to our structural heart coordinators at 530-332-4430.

What other procedures does Enloe Health Structural Heart & Valve Center offer?

Enloe Health Structural Heart & Valve Center offers:

  • Transcatheter Aortic Valve Replacement (TAVR)
  • Balloon Aortic Valvuloplasty (BAV)
  • Patent Foramen Ovale (PFO) closure
  • Atrial Septal Defect (ASD) closure
  • Ventricle Septal Defect (VSD) closure
  • Patent Ductus Arteriosus (PDA) closure
  • Left Atrial Appendage Closure (LAAC) 
  • Mitral Valve Repair for regurgitation or prolapse

Contact Us

Enloe Health Structural Heart & Valve Center

  • Nursing Coordinators:
    530-332-4430
  • Clinic: 530-332-4388

Contact Us Online

Hours: Monday through Thursday,
8 a.m. to 5 p.m.; Friday 8 a.m. to noon

(closed for lunch from noon to 1 p.m.)

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