Transcatheter Aortic Valve Replacement (TAVR)
North Mississippi Medical Center in Tupelo was the first Mississippi hospital to offer transcatheter aortic valve replacement (TAVR), an alternative for high-risk patients with aortic stenosis for whom heart surgery is not an option.
Since 2012, we have been replacing aortic valves without the need for open heart surgery. TAVR is performed on a beating heart and does not require cardiopulmonary bypass or a large chest incision.
A cardiologist-cardiothoracic surgeon team replaces a diseased valve in one of two ways.
In the transfemoral method, the valve is delivered through an incision in the leg.
NMMC was also the first to perform transapical TAVR for patients who don’t have suitable access through their leg artery. In the transapical method, the physician inserts the valve through an incision between the patient’s ribs and through the bottom end of the heart called the apex.
We perform both procedures in our hybrid OR, which combines operating room capabilities with the most advanced imaging systems available.
The patient usually goes home in the next day or two from a femoral approach and within two to three days for an apically placed valve.
Following discharge, most patients are seen within the next week. Patients generally continue their previous home medications plus Plavix for the next six to eight weeks. Patients have follow-up echocardiography upon discharge and usually yearly thereafter.
Who Can Benefit
Current guidelines recommend TAVR for patients with severe calcific aortic stenosis who are considered at high risk for open heart surgery. Candidates are generally older patients in their late 70s to 90s. Often they have many conditions, including complex cardiovascular disease and lung disease.
Any patient, surgical or non-surgical, can be referred to our Valve Center. Cardiologists and surgeons collaborate to determine the best strategy.
You will have an echocardiogram to confirm severe aortic stenosis and quantify ejection fraction. The echocardiogram also checks for co-existing valve disease, including severe aortic insufficiency, that might prohibit a TAVR procedure. Patients will undergo CT scanning of the chest, abdomen and pelvis with contrast to map out aortic and femoral arteries.
A cardiac CT will determine adequate sizing of the transcatheter aortic valve. We perform a left heart catheterization to assess for co-existing coronary artery disease that we may need to address or stent before the procedure.