Transcatheter Aortic Valve Replacement (TAVR) is a minimally invasive procedure that replaces a diseased aortic valve without requiring open-heart surgery. This technique involves threading a new valve through a catheter, typically inserted via an artery in the groin, which significantly shortens the recovery period compared to traditional surgery. Understanding the phases of recovery is important for patients and caregivers to manage expectations and achieve the best long-term outcome.
Immediate Post-Procedure Hospital Stay
Following the successful placement of the new valve, patients are moved to a transitional care unit or the intensive care unit for close observation. Monitoring is continuous, focusing on heart rate, blood pressure, and rhythm. An echocardiogram is performed immediately after the procedure to ensure the new valve is functioning correctly.
Most patients can expect a hospital stay of one to three days. Early mobilization is encouraged, with many patients walking short distances within 24 hours. Before discharge, all lines and catheters are removed, and the care team provides detailed instructions on incision care and new medications.
Navigating the First Weeks of Home Recovery
The first four to six weeks at home mark a period of noticeable recovery, though energy levels may fluctuate significantly. General fatigue and a reduced appetite are common for the first couple of weeks, even if heart symptoms have improved. Daily activity is encouraged to build strength, starting with short walks that can be gradually lengthened over time.
Caring for the catheter insertion site, usually in the groin, is a major focus. The site may show bruising or a small lump, which is normal and can take several weeks to fade. Patients must keep the area clean and dry, washing it gently with soap and water. Soaking the incision in a bathtub, hot tub, or pool should be avoided until it is fully healed, typically about one week.
Activity restrictions are in place to ensure the access site heals properly and to protect the new valve. Patients should not lift anything heavier than 5 to 10 pounds for the first one to four weeks, including groceries or small children. Strenuous activities like vacuuming or yard work are restricted for up to six weeks. Driving is restricted for a minimum of 72 hours or up to a week, especially if the patient is taking narcotic pain medication.
Essential Long-Term Follow-Up Care
After initial recovery, long-term monitoring and commitment to medical regimens are necessary to ensure the continued success of the TAVR procedure. Regular follow-up appointments with the cardiology team are scheduled, including a comprehensive evaluation at 30 days post-procedure. Subsequent visits typically occur at six months and then annually to monitor the heart and valve function.
Diagnostic imaging, specifically an echocardiogram, is performed at the one-month mark and then annually to assess the new valve’s performance and blood flow. Medication adherence is a lifelong requirement, particularly regarding blood thinners or antiplatelet therapy. Most patients are prescribed a combination of lifelong aspirin and another antiplatelet medication, such as clopidogrel, for three to six months to prevent clot formation.
Another lifelong precaution involves dental health to prevent infective endocarditis, an infection of the heart valve. Patients must inform all healthcare providers, including dentists, that they have a prosthetic heart valve. Prophylactic antibiotics are required before certain dental procedures to reduce the risk of bacteria settling on the new valve.
When to Seek Urgent Medical Attention
While mild pain and fatigue are expected during recovery, certain symptoms warrant immediate medical attention, as they can signal a serious complication. The following symptoms require urgent contact with the care team or emergency services:
- Severe, sudden shortness of breath that is new or rapidly worsening.
- Severe chest pain, pressure, or tightness that does not subside.
- Signs of infection at the catheter site, such as fever, increased redness, swelling, or drainage of pus.
- Sudden, unexplained weight gain (more than three to five pounds over a few days), which can indicate fluid retention or potential heart failure.
- Fainting, sudden swelling, or uncontrolled bleeding at the groin access site that does not stop after ten minutes of firm pressure.
- Any signs of stroke, such as sudden weakness or difficulty speaking.