Have Questions About Aortic Stenosis? We have Answers.

Aortic stenosis is a progressive condition caused by a narrowing of the aortic valve, which prevents normal blood flow. Because the condition will get worse with time, doctors will measure it as mild, moderate, or severe (depending on how damaged the valve is). The condition affects more than 2.5 million people over the age of 75 in the United States.

There are four main causes of aortic stenosis: calcium build-up on the valve leaflets, birth defects that may impact the structure of the aortic valve, rheumatic fever which can cause scar tissue to form in the heart, and radiation therapy.

If aortic stenosis goes untreated, it will progress to the severe stages of the disease. Severe aortic stenosis means the aortic valve has a severe build-up of calcium and has a difficult time opening and closing. Your heart may need to work harder to pump blood throughout your body.

Once aortic stenosis progresses to the severe stages, symptoms such as shortness of breath, chest pain, fatigue, or lightheadedness may occur. It is important to tell your doctor right away if you experience symptoms or if your symptoms worsen.

Symptoms of severe aortic stenosis include shortness of breath, chest pain, fatigue, lightheadedness, rapid or irregular heartbeat, swollen ankles/feet or difficulty exercising. These symptoms may indicate your aortic stenosis has progressed to a life-threatening point.

Approximately 50 percent of people who develop severe aortic stenosis symptoms will die within an average of two years if they do not have their aortic valve replaced. If you have been diagnosed with severe aortic stenosis and have symptoms, talk to your doctor right away about your treatment options.

Your doctor will perform a few tests to determine if you have aortic stenosis. This is primarily done by listening to the sounds of your heart with a stethoscope. Diagnosis may also be done through a test called echocardiogram, which uses ultrasound waves to obtain images of the heart chambers and valves.

Depending on how far your aortic stenosis has progressed, your doctor may prescribe medication to help control your symptoms. However, it’s important to know the only effective way to treat aortic stenosis is by replacing your valve. This can be done through transcatheter aortic valve replacement (TAVR) or open heart surgery.

TAVR (also known as transcatheter aortic valve implantation or TAVI for short) is a less invasive procedure for replacing a diseased aortic valve. During the procedure, your TAVR Doctor will use a catheter to implant a new valve within your diseased valve. TAVR can be performed through multiple approaches, however, the most common is through a small incision in the leg.

TAVR can be performed in different ways depending on each individual’s anatomy.

• The transfemoral approach is the most common approach and is through an incision in the leg.
• The subclavian approach is through an incision near the shoulder.
• The transapical approach is through an incision in the chest between the ribs.
• The transaortic approach is through an incision in the upper chest.

With the less invasive TAVR procedure, people may return to daily activities sooner than with open heart surgery. People who undergo TAVR report improved quality of life following the procedure. Other TAVR benefits include: short hospital stay, relief of symptoms (sometimes immediately), improved heart function, and reduced pain and anxiety.

Depending on your health and the procedural approach recommended by your doctor, the average TAVR procedure lasts approximately 1.5 hours. In comparison, the average open heart surgery lasts approximately 4 hours.

How long your transcatheter heart valve will last depends on many factors and will vary per person. However, regular follow-ups will help your doctor know how your valve is working.

TAVI stands for transcatheter aortic valve implantation. The procedure and its approaches are the same as TAVR. Your doctor may use the terms interchangeably when discussing your treatment options.

TAVR has been commercially available in Europe since 2007 and in the United States since 2011.

Transcatheter heart valves are made by different manufacturers. You can check which valves are used and available at your hospital. Although you can ask for a specific valve, your TAVR Doctor will recommend the best valve for you.

Learn More About Edwards Transcatheter Heart Valves

You should contact your insurance carrier directly prior to your first appointment with your TAVR Doctor to determine if your TAVR evaluation and TAVR procedure are covered, and if a referral is required.

The Centers for Medicare and Medicaid Services (CMS) cover TAVR under certain conditions. You can learn more by visiting our Helpful Websites page.

Learn More on Our Helpful Websites Page

TAVR used to only be available for people who were too weak to undergo open heart surgery. But now, the procedure is available to more people depending on their risk for open heart surgery. It is also an option for people who previously had their aortic valve replaced. You need to consult an interventional cardiologist at a TAVR Hospital to determine if TAVR is an option for you. You can use our Find a TAVR Hospital tool to identify the nearest location to you.

Your doctor may use one or more of these tests to determine if TAVR is the best option for you.

• Chest X-ray: A type of imaging to view images of the organs and structures inside your chest. You will be placed between a metal plate and the x-ray machine. The x-ray technician will take several images of your chest in a variety of positions. This may take up to 30 minutes to perform.
• Transthoracic echochardiogram (TTE): This diagnostic test (also known as an echo) uses ultrasound to obtain 3D images of the heart. While you are lying on a table, a probe will be placed on your chest wall and will use sound waves to provide detailed pictures of your heart. This usually takes 30-60 minutes.
• Magnetic resonance imaging (MRI): A diagnostic test that uses magnetic and radio waves to take detailed pictures of your heart. You will be asked to lie down on a bed that moves into a large tube. You won’t feel anything but will hear a noise as the images are acquired. You will be asked to lie very still for duration of test.  This usually takes 30-90 minutes.
• Pulmonary function test (PFT): A group of tests, using special breathing equipment, that will measure how well your lungs are moving oxygen to the blood. These can take 60-120 minutes.
• Computerized tomography (CT) scan: An imaging test that uses x-rays to obtain detailed pictures of your heart and blood vessels. You will be injected with contrast dye through an IV. You will be asked to lie down on a bed that passes through a donut-shaped x-ray scanner to take clear images of your heart.  This takes up to 60 minutes.
• Angiogram (cardiac cath): An imaging test that uses x-ray and dye to see how blood flows through your arteries and veins. You will lie on your back on an x-ray table. A small incision will be made and a small tube, called a catheter, will be inserted either in your groin or near your elbow. Dye will be injected into the vessel to make the area show clearly on the x-ray pictures. This takes up to 60 minutes.
• Transesophageal echocardiogram:  A test that obtains detailed pictures of your heart by inserting a probe down the esophagus (throat).  While lying on a table, a technician will spray your throat with medicine to numb and supress your gag reflex. A thin flexible tube will be guided down your throat. The probe will send and receive sound waves which will become pictures on a video screen. This may take up to 60 minutes.

To see if the TAVR procedure is right for you, you need to seek out expert care from a specialized heart doctor called an interventional cardiologist at a TAVR Hospital. Only a TAVR Hospital can evaluate you for both TAVR and open heart surgery to determine what the best treatment option is for you.

Not all hospitals perform TAVR, but you can find the nearest TAVR Hospital using the Find a TAVR Hospital Tool.

You may have heard the term Heart Team while researching your aortic stenosis treatment options. A Heart Team is a specialized care team that includes interventional cardiologists, cardiothoracic surgeons, imaging specialists, anesthesiologists, cardiac cath lab staff, and a cardiologist. Together, the specialized Heart Team will conduct a comprehensive evaluation to determine whether the TAVR procedure is appropriate for you.

If your doctor doesn’t perform TAVR, you should ask for a referral to a TAVR Hospital. The doctors at a TAVR Hospital are experts in valvular disease and valve replacement and are able to determine the best treatment option for you. Find the nearest TAVR Hospital.

If your doctor does not think you are a good candidate for TAVR, you may still contact a TAVR Hospital to receive a second opinion.

Find a TAVR Hospital

Typically following a TAVR procedure, you may be taken to the intensive care unit (ICU) for a little while or moved directly to a recovery room. Your doctor will update your caregiver or loved ones on how you are doing.

Research has shown that patients that undergo the less invasive TAVR procedure have improved health within 30 days of their procedure. To optimize your recovery, your doctor will give you specific instructions, which may include a special diet, exercise, and medication therapy. It is important to carefully follow your doctor’s directions, especially if blood-thinning drugs are prescribed.

There are many free patient resources available to learn more about aortic stenosis and TAVR, including patient stories, TAVR brochures and procedure videos. A personalized information kit is also available to help answer your questions on aortic stenosis and TAVR.

You can get connected with others who have gone through TAVR and ask them questions and hear their stories through the Edwards PatientConnect program. Simply call our toll-free number (1-877-209-8638) or fill out the Edwards PatientConnect program form and a dedicated team member will reach out to help you get started.

Get Support

There are a variety of helpful websites that may provide additional information on diagnosis and treatment of aortic stenosis as well as support services. Visit our helpful websites page to learn about these available resources.

Learn More on Our Helpful Websites Page

You can search for TAVR Hospitals by zip code, city/state, or by hospital name using our Find a TAVR Hospital tool. Once you find a TAVR Hospital near you, you may click on the provider to view listing details.

Find a TAVR Hospital