Transcatheter Aortic Valve Replacement: Before Your Procedure

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What is transcatheter aortic valve replacement?

The heart

Transcatheter aortic valve replacement (TAVR) is a procedure to replace the aortic heart valve. Your doctor will use a catheter to put in your new heart valve. You won't need open-heart surgery.

TAVR is often done through a cut (incision) in the groin. But sometimes a small cut is made in the chest. Your doctor will use a tube called a catheter and special tools that fit inside it. The doctor puts the catheter into a blood vessel and moves it into the heart.

An artificial valve fits inside the catheter. Your doctor will move the new valve into your damaged valve. It will expand and work in place of the old valve.

You will probably be asleep for the procedure.

You will have to stay in the hospital for a few days.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What happens before the procedure?

Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare.

Preparing for the procedure

  • Understand exactly what procedure is planned, along with the risks, benefits, and other options.
  • Tell your doctor ALL the medicines and natural health products you take. Some of these can increase the risk of bleeding or interact with anesthesia.
  • If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your procedure. Make sure that you understand exactly what your doctor wants you to do.
  • Your doctor will tell you which medicines to take or stop before your procedure. You may need to stop taking certain medicines a week or more before the procedure. So talk to your doctor as soon as you can.
  • You will have several tests to get ready. These may include echocardiograms and a CT scan.
  • If you have an advance care plan, let your doctor know. Bring a copy to the hospital. If you don't have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes. Doctors advise that everyone prepare these papers before any type of surgery or procedure.

What happens on the day of the procedure?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your procedure may be cancelled. If your doctor told you to take your medicines on the day of the procedure, take them with only a sip of water.
  • Take a bath or shower before you come in for your procedure. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Take off all jewellery and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery centre

  • Bring a picture ID.
  • You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.
  • The procedure will take between 2 and 5 hours. The time depends on the size and shape of your arteries and heart.
  • After the procedure, pressure will be applied to the area where the catheter was put in your blood vessel. Then the area may be covered with a bandage or a compression device. This will prevent bleeding.
  • Nurses will check your heart rate and blood pressure. The nurse will also check the catheter site for bleeding.
  • If the catheter was put in your groin, you will need to lie still and keep your leg straight for several hours. The nurse may put a weighted bag on your leg to keep it still.
  • You may have a bruise or a small lump where the catheter was put in your blood vessel. This is normal and will go away.

Going home

  • Be sure you have someone to drive you home.
  • You will be given more specific instructions about recovering from your procedure. They will cover things like diet, follow-up care, and getting back to your normal routine.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your procedure.
  • You become ill before the procedure (such as fever, flu, or a cold).
  • You need to reschedule or have changed your mind about having the procedure.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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