TAVR is a minimally invasive cath-based procedure to replace the aortic valve in a patient with severe aortic stenosis.

It's for individuals that are high risk or too sick for open heart surgery.

Left untreated, aortic valve stenosis can lead to more serious heart problems.

Dr. George Hodge from UnityPoint Health Cardiology Clinic explains the procedure and who is a candidate for TAVR.

The aortic valve is one of the heart valves.

There are four valves in the heart.

The aortic valve is the valve that sits between the left bottom chamber of the heart, we call it left ventricle, which is the main chamber of the heart that pumps the blood to the whole body, and between the aorta, which is the blood vessel, the largest blood vessel that we have, that comes out of this left ventricle and distributes the blood to the whole body.

And this valve opens and closes.

It opens when the heart is squeezing, when this left ventricle is contracting to let the blood flow to the whole body, and closes when this left ventricle is relaxing and filling with blood in order to prevent the blood that was just ejected by this ventricle from leaking backwards into it.

And aortic stenosis, aortic, refers to the aortic valve, stenosis refers to, refers to inability of this valve to open very well.

And the ventricle, although may be working normally, the valve not being able to open will decrease blood flow basically to the whole body.

That usually translates into symptoms with exertion, shortness of breath with exertion, chest discomfort with exertion, dizziness with exertion, because the brain is not getting enough blood flow, the heart is not getting enough blood flow, and blood is being backed up and filling the lungs, which could cause the shortness of breath with exertion.

So when we have severe degree of this aortic valve stenosis, and we have symptoms, it is highly recommended to fix this valve.

There are no medications currently that will slow the progression of this disease or cure it.

The only treatment is a procedure.

There are two ways we can do this.

Classically, we replace the aortic valve surgically.

The surgeon cuts the chest open, stops the heart, uses an artificial heart for a certain amount of time, enough for him or her to remove the defective valve and place a prosthetic valve in place.

Then the heart is restarted, artificial heart is stopped, chest is closed.

And this is typically what we call AVR, aortic valve replacement.

Now, over the last few years, there has been a lot of advances in how we do this treatment.

And we added a T before the AVR and it becomes TAVR, so transcatheter aortic valve replacement.

And that refers to replacing the heart valve without cutting the chest open by making an incision in the groin and accessing the artery that's in the groin, and from there going back to the heart and placing a valve inside the patient's previous valve.

We use the defective valve to anchor the new valve in place.

This old defective valve gets crushed against the wall of the aorta, which is that blood vessel that comes out of the left ventricle, and this new valve starts functioning immediately.

Our patient undergoing TAVR is Donald Waterman, an 88-year-old from eastern Iowa.

He was experiencing a rapid and irregular heart rate and went to St.

Luke's ER.

Up to that point in time, Waterman had been closely monitored by a UnityPoint Health cardiologist.

With this change in condition, it was determined he would undergo the TAVR procedure.

I would say about at least a third of the patients have been able to go home the next morning after having their heart valve replaced the day before.

And the team has grown and we now are implanting all the valves that are on the market, all the different valves.

And of course, each valve has certain features and certain patients may benefit more from one or the other.

Most patients will do very well with either one of the valves.

Family reports Waterman is feeling less tired after his procedure and feel he was in the right place at the right time.

They indicate his quality of life is better and feel fortunate to have this option in Cedar Rapids, allowing them to stay close to home and avoid travel.

Patient satisfaction has been great.

And again, I want to remind patients that this treatment, currently at least, is mainly for patients who are at intermediate or high risk of having complications or dying from an open, classical, open heart surgery with valve replacement with a surgeon alone.

For the patients who are at a low risk, we don't know yet if they'll do well or not.

Currently, this is being studied in the research trials.

So for patients who are elderly, who are frail, and again, we calculate a score that tells us what is the chance that this patient is going to have a major complication from a classical open heart surgery.

And if it says that it's intermediate or if it's high, then we tend to do TAVR.

And mainly because it has been proven that TAVR is either equal or superior in these patients, especially in the patients that are high risk is actually superior to surgery and the intermediate risk is similar to surgery.

With the advantage of quicker recovery, less pain and discomfort going home sooner as opposed to classical open heart surgery.

UnityPoint Health Cedar Rapids Heart and Vascular Institute offers advanced technologies and procedures to help patients stay close to home.

We invite you to learn more about UnityPoint Health Heart Care Services and how to prevent heart disease.