Transcatheter Aortic Valve Replacement (TAVR)
Transcatheter aortic valve replacement is a relatively new procedure that delivers a replacement valve in much the same way that a cardiac stent is implanted. This procedure does not require stopping the heart or opening the chest cavity. These revolutionary valves, constructed from a combination of metal mesh and animal tissue, are delivered via a thin wire (catheter) and expanded in place over the existing valve. Once in place, the valve immediately begins functioning.

Heart Team Approach
A group of doctors called the“Heart Team” is involved inmaking a determination if you are a candidate for a TAVR procedure. This includes interventional cardiologists,cardiothoracic surgeons,echocardiographers,
anesthesiologists, and valve clinic coordinators.

Candidates for the TAVR Procedure
A series of tests and consultations will be done to see if you can have this procedure. Patients can be admitted to the hospital for the tests or patients can schedule the tests as an outpatient. If the tests show this procedure is right for you, you will return at a later date for the TAVR procedure.
Workup tests include:
Echocardiogram – an ultrasound of your heart chambers and valves.
Chest/Abdomen/Pelvis CT with contrast dye – a view of the size and shape of your blood vessels and aortic valve.
Right and Left Heart Catheterization – a check of the blood flow in your arteries around the heart and the blood pressures in your heart.
Pulmonary Function Test – a measure of how your lungs are functioning.
Carotid Doppler Ultrasound – a test to see the blood flow of the carotid artery in your neck.
Consultation with an Interventional Cardiologist and a Cardiac Surgeon – You will meet with an interventional cardiologist and a cardiac surgeon. They will explain more about the TAVR procedure and review your treatment options. The test results will be reviewed by the TAVR Heart Team to determine if you are a candidate. You will then be contacted with the results.

Available TAVR Devices
If you are reading this guide, chances are you’ve been recommended for a transcatheter aortic valve replacement (TAVR) procedure at Mount Sinai Heart. TAVR, also sometimes called TAVI for transcatheter aortic valve implantation, offers options for patients who may not be candidates for surgery due to their overall health, age, or other medical conditions. Mount Sinai Heart is a leader in this emerging treatment,and we were one of the first hospitals in the New York metropolitan area to offer both TAVR treatment options available in the United States: the Edwards SAPIEN® Valve and the Medtronic CoreValve ® System.Both devices have been thoroughly researched and tested, and each offers advantages for certain cases.The TAVR Heart Team (interventional cardiologists, cardiothoracic surgeons, and echocardiography) will determine the device that is appropriate for you.
Regardless of which device your doctor chooses for your case, you will be treated by an experienced multidisciplinary team that includes interventional cardiologists, cardiac surgeons, an echocardiographer,
anesthesia, intensivists, nurse practitioners, clinical nurses, research coordinators, and other support staff.

Delivery of the TAVR Device
The arteries in the body are like a system of roads that branch out from
the heart. There are different “routes” to get to the heart to deliver the valve.
These include:
• An artery in your leg (femoral) —this is the most common approach.
• An artery near your collarbone(subclavian)
• A space between your ribs(direct aortic)

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