Transcatheter Aortic Valve Replacement (TAVR) is a minimally invasive procedure designed to replace a narrowed aortic valve, a condition known as aortic valve stenosis. This innovative approach offers an alternative to traditional open-heart surgery, which involves a larger incision through the breastbone. TAVR uses small cuts and a flexible tube, called a catheter, to guide a new valve made from animal tissue into the heart, where it expands and takes over the function of the diseased valve.
Immediate Post-Procedure Hospital Stay
Following a TAVR procedure, patients typically spend time in a recovery area or intensive care unit (ICU) where medical staff closely monitor their condition. Nurses continuously observe heart rate, rhythm, and blood pressure. Intravenous (IV) lines are used to administer medications, fluids, and blood as needed, though most are removed within about 12 hours. Patients can expect some aches and pains in their back, shoulders, neck, and chest, which are part of the normal healing process and can last up to a month. Pain medication is often prescribed to manage this discomfort.
Early mobilization is encouraged, with many patients able to sit up and take short walks within 24 hours after the procedure. A urinary catheter is usually removed about 24 hours post-surgery. The length of hospital stay is generally shorter compared to open-heart surgery, often ranging from one to five days, depending on the individual’s overall health and the specific approach used for the procedure. Some patients, depending on their recovery, may even be discharged directly from the ICU.
Navigating Recovery at Home
Patients generally need to limit lifting anything heavier than 10 pounds for about one week if the procedure was performed through the groin, but this restriction can extend up to eight weeks for procedures involving a chest incision. Driving is typically restricted for one to four weeks or until pain medications are no longer needed and comfortable movement is restored. Strenuous activities should be avoided for at least one to four weeks, with gradual increases in activity levels as recovery progresses.
Incision site care is important; the area should be kept clean and dry, washed gently with soap and water daily. Patients should avoid soaking the incision in baths, hot tubs, or swimming pools until it is fully healed, which usually takes about two weeks, though showering is permitted. It is common for the insertion site to appear bruised for several weeks. Medication adherence is important, particularly for blood thinners, which are often prescribed for around six months to prevent blood clots on the new valve, alongside other heart medications.
A heart-healthy diet, rich in fruits, vegetables, whole grains, lean proteins, and healthy fats, is recommended. Limiting sodium intake is also advised to help manage blood pressure. Common post-TAVR symptoms can include fatigue, mild discomfort, and temporary changes in taste or temperature sensation. Addressing emotional well-being is also important, as anxiety about returning home is normal. Gradually returning to daily activities, with rest periods as needed, aids healing. Cardiac rehabilitation programs are often recommended to provide supervised exercise and education on heart-healthy living.
When to Seek Medical Attention
Individuals should contact their healthcare provider or seek emergency care if they experience certain specific symptoms. Signs of infection at the incision site, such as increasing redness, warmth, swelling, new drainage, or a fever of 100.4°F (38°C) or higher, warrant prompt evaluation. Significant bleeding from the incision site that does not stop after applying direct pressure for 10 minutes, or sudden swelling at the site, also requires immediate help.
Other concerning symptoms include severe or worsening chest pain, pressure, or tightness, as well as severe or sudden shortness of breath. Neurological changes, such as new confusion, slurred speech, sudden vision changes, a sudden severe headache, or symptoms indicative of a stroke (facial drooping, arm weakness, speech difficulty), demand immediate emergency attention. Dizziness, fainting spells, swelling in the ankles or legs, or sudden weight gain (e.g., more than three pounds in two days) should also prompt a call to the doctor.
Long-Term Outlook and Follow-Up Care
Life after TAVR involves sustained health management and a heart-healthy lifestyle. Regular follow-up appointments with cardiologists monitor the new valve’s function and overall heart health. These check-ups are scheduled one month and then one year after the procedure, and may include diagnostic tests like echocardiograms to assess valve performance. Ongoing medication management, including heart medications and blood thinners as directed, helps prevent complications and supports long-term outcomes.
Maintaining a heart-healthy lifestyle includes a balanced diet, regular physical activity, and avoiding smoking. Consulting with healthcare providers before starting new exercise routines is advised to ensure activities are appropriate and safe. Individuals with prosthetic heart valves should inform all their doctors, including dentists, as preventive antibiotics may be necessary before certain procedures to reduce the risk of infection. TAVR aims to relieve symptoms of aortic stenosis and improve quality of life, allowing many patients to experience significant symptom relief and a return to more active daily routines within months.