Transcatheter Aortic Valve Replacement

TAVR doesn't involve open-heart surgery. But the procedure does have serious risks. Some risks last just a short time. Others are long-term.

Risks include:

• Heart block. This is a problem with the electrical system in the heart. It can cause a slow heart rate. If this happens, a person may need a permanent pacemaker.
• Injury to the blood vessel used to put the catheter in the heart.
• Serious bleeding problems.
• Leaking around the valve.
• Heart attack.
• Stroke.
• Death.

This procedure can help people who have aortic stenosis feel better and live longer.

But how well this procedure works depends on several things, such as other health problems that a person has. These include other heart problems. Doctors are still learning who might benefit the most from TAVR.

Because TAVR is a newer treatment, doctors don't yet know the long-term benefits or risks. They also don't know how long the valves will last. But research shows that they work well for at least five years.

• While you are in the hospital, your doctors and nurses will monitor you to check how the new valve is working.
• You will receive information from the hospital about diet, activities, and medicine.
• You will need to have regular checkups with your doctor.
• Your doctor may suggest that you attend a cardiac rehab program. In cardiac rehab, a team of health professionals provides education and support to help you recover and prevent problems with your heart. Ask your doctor if rehab is right for you.
• You may take aspirin or some other blood thinner to prevent blood clots. If you get a blood thinner, be sure you get instructions about how to take your medicine safely. Blood thinners can cause serious bleeding problems.

Activity

• Do not do strenuous exercise and do not lift, pull, or push anything heavy until your doctor says it is okay. This may be for several days.
• If the catheter was placed in your groin, try not to walk upstairs for the first couple of days.
• Rest when you feel tired.
• Ask your doctor when you can drive again.

Diet

• Eat a heart-healthy diet. If you have not been eating this way, talk to your doctor. You also may want to talk to a dietitian. They can help you learn about healthy foods.
• If your bowel movements are not regular right after the procedure, try to avoid constipation and straining. Drink plenty of water. Your doctor may suggest fiber, a stool softener, or a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Your doctor may prescribe aspirin or some other blood-thinning medicine. Be sure to get instructions about how to take your medicine safely. Blood thinners can cause serious bleeding problems.
• Be safe with medicines. Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.

Care of the catheter site

• For 1 or 2 days, keep a bandage over the spot where the catheter was inserted. The bandage probably will fall off in this time.
• Put ice or a cold pack on the area for 10 to 20 minutes at a time to help with soreness or swelling. Put a thin cloth between the ice and your skin.
• You may shower 24 to 48 hours after the procedure, if your doctor okays it. Pat the incision dry.
• Do not soak the catheter site until it is healed. Don't take a bath for 1 week, or until your doctor tells you it is okay.
• Watch for bleeding from the site. A small amount of blood (up to the size of a quarter) on the bandage can be normal.
• If you are bleeding, lie down and press on the area for 15 minutes to try to make it stop. If the bleeding does not stop, call your doctor or seek immediate medical care.

Other

• Practice good dental hygiene and have regular checkups. Good dental health is especially important. That's because bacteria can spread from teeth and gums to the heart valves.
• Be sure to tell all your doctors and your dentist that you have a replacement aortic valve. This is important because you may need to take antibiotics before certain procedures to prevent infection.