Good morning everyone. Welcome back and today we will be discussing about surgical aortic valve replacement (SAVR) vs transcatheter aortic valve replacement (TAVR).
Aortic Valve and Valve Disease
To start, the aortic valve is the valve that functions as a door between the heart and the aorta. When the valve is damaged and/or not functioning well, the condition is called aortic valve disease. When aortic valve disease is mild there may be no symptoms at all, but as time passes and the condition may get worse, so the heart has to work harder against the valve and can damage the heart. When this occurs, symptoms such as chest pain or difficulty breathing develops. Two common forms of aortic valve disease exist, which are aortic stenosis and aortic regurgitation. In aortic stenosis, the aortic valve has trouble opening due to a narrow or thickened valve for enough blood to flow from the heart to the aorta each time the heart beats. In aortic regurgitation, the aortic valve might not be closing enough or properly, causing blood to leak backwards into the heart instead of going to the aorta with each heart beat.
What is surgical aortic valve replacement and transcatheter aortic valve replacement?
Surgical aortic valve replacement (SAVR) is an open surgery for the aortic valve and can treat either aortic stenosis or aortic regurgitation. This requires an incision or cut in your chest bone to access the heart. A key consideration of undergoing SAVR is determining which valve to receive, as there is the option of receiving a biological valve that is made from a pig or cow heart tissue, or a mechanical valve, which is made of carbon and steel, that will require life-long blood-thinning medications called Warfarin or Coumadin to help reduce the risk of blood clots as blood clots are more likely to form with mechanical valves. Each valve has its pros and cons, and the surgeon can talk about which valve is recommended based on factors such as age and lifestyle.
Transcatheter aortic valve replacement (TAVR) on the other hand is a minimally invasive approach that can be used to treated aortic stenosis. Below is a diagram that illustrates how a TAVR balloon is placed at the site of the thickened and narrowed aortic valve and expanded open to treat aortic stenosis. During TAVR, a doctor will guide the catheter using X-ray and imaging guidance to replace the damaged aortic valve with a biological valve.
Compared to SAVR, TAVR uses smaller incisions often at the groin for a tube-liked catheter to be directed through blood vessels to the site of the aortic valve, rather than the often large incisions at the chest bone known as a sternotomy required for SAVR. TAVR is an option for people who can't have heart surgery to undergo SAVR to replace the aortic valve. For SAVR, there are options for smaller incisions known as a partial sternotomy or by right anterior thoracotomy. However, since TAVR is less invasive, the length of hospitalization is much shorter than the post-operative hospital stay for SAVR.
If you think or have known aortic valve disease, please discuss your concerns and options with your doctor. This is by no means a comprehensive description or guide between SAVR and TAVR but rather meant to be brief overview comparing the two approaches.
And that’s what we have today! Thank you for tuning in and please join us back here next week.
Have a wonderful week and stay healthy.