If you are a high-risk patient with aortic stenosis, you may be a candidate for a minimally invasive procedures called a transcatheter aortic valve replacement (TAVR). In this procedure, the valve is advanced to your heart with a catheter and mounted on a stent frame within the diseased valve, eliminating your need for open-heart surgery.
Aortic Valve Replacement
Treatment options for the aortic valve have had an explosive evolution. The aortic valve is most commonly affected by calcium that develops with aging. In addition, infections may result in affecting how the valve works. The valve also can leak, either from aging, calcium, infection and other reasons.
Aortic stenosis is the most common reason for an aortic valve replacement. One effective but less common treatment option is transcatheter aortic valve replacement or TAVR. In addition to TAVR, we use three primary options:
- Standard sternotomy—This requires which requires an incision through the middle of the breastbone which is then fused completely at the completion of the procedure so as to eliminate any discomfort from the breastbone. Our anesthesia team works closely with the patients to maximize pain control and minimize any discomfort.
- Minimally invasive surgery—We have two approaches, and for both we assess each person’s anatomy and medical condition to choose the surgery that is safest. The first and most common surgery goes through half the breastbone. The second approach is through an incision on the right side of the chest.
- Essentially all open aortic valve replacement procedures require the use of the heart-lung machine, which was pioneered at the University of Minnesota.
Aortic Valve Repair
Sometimes the aortic valve may not need complete replacement. This is most commonly with a leaky aortic valve. If a patient has a leaky aortic valve, we may replace it with a biological or mechanical valve, but occasionally we may find a very specific mechanism for why the valve is leaky. If that mechanism can be corrected, surgical repair may be a better option than replacement.