Transcatheter Aortic Valve Replacement (TAVR) is a minimally invasive surgical procedure used to replace a narrowed aortic valve that can’t open properly (aortic valve stenosis). TAVR is often used for patients who are considered at intermediate or high risk for traditional open-heart valve replacement surgery. The survival rate for TAVR depends on several factors, including the patient’s overall health, age, and the severity of the aortic stenosis. Here’s an overview of the survival rates based on recent studies and clinical data:
Survival Rate
- General Success Rate:
- The success rate of TAVR is generally high. Studies have shown that the procedure has a high success rate in terms of procedural success and short-term survival.
- The one-year survival rate after TAVR is typically above 80%, and in many studies, it’s over 90%.
- Factors Affecting Survival:
- Patient’s Health: Co-existing medical conditions, especially those related to the heart and lungs, can affect outcomes.
- Age: Older patients may have a slightly higher risk of complications, though age alone is not a disqualifying factor.
- Severity of Aortic Stenosis: More severe cases pose greater risks both during and after the procedure.
- Experience of the Medical Team: The skill and experience of the medical team performing TAVR can impact success rates.
Complications and Considerations
- Complications:
- Potential complications can include stroke, vascular complications, bleeding, and issues related to the heart valve, like leakage around the new valve.
- Newer generations of TAVR devices and evolving techniques have reduced these risks.
- Recovery Time:
- Recovery from TAVR is typically faster than from traditional open-heart surgery, often with a shorter hospital stay.
- Long-term Outcomes:
- Long-term data on TAVR is still being gathered, but results so far are promising, showing good valve function and quality of life.
- Patients require lifelong follow-up to monitor valve function and general heart health.
Conclusion
TAVR has become a highly successful option for treating severe aortic stenosis, especially in patients who are at high risk for traditional surgery. Its minimally invasive nature allows for quicker recovery times and is generally well-tolerated by patients, including older adults. However, the decision to proceed with TAVR should be made after a thorough evaluation by a cardiac team, considering all individual health factors and potential risks.
Frequently Asked Questions
What is the biggest risk with TAVR?
The major risks include stroke, vascular complications, potential for heart block requiring a pacemaker, and paravalvular leak (leakage around the new valve).
What is life expectancy after TAVR?
Life expectancy varies significantly based on the patient’s age, overall health, and comorbidities. Many patients experience a significant improvement in quality of life and symptom relief.
Can you live 20 years after heart valve replacement?
It’s challenging to predict a 20-year survival specifically for TAVR patients, as many are older and have other health conditions. The durability of TAVR valves over such an extended period is still being studied.
Do people feel better after TAVR?
Many patients report significant improvement in symptoms like breathlessness and fatigue, leading to a better quality of life.
Can you live a long life after TAVR?
While possible, it largely depends on individual health factors and the presence of other medical conditions.
What are the downsides of TAVR?
Risks include potential for stroke, vascular injury, need for permanent pacemaker, and the longevity of the valve compared to surgical replacements.
Should a 90 year old have a TAVR?
TAVR can be a suitable option for patients in their 90s, depending on their overall health, functional status, and goals of care.
How often does TAVR fail?
Actual “failure” is relatively rare but can include issues like valve degeneration, thrombosis, or migration. The procedure has a high success rate.
How common is stroke after TAVR?
Stroke is a risk, although its incidence has decreased with advances in technology and procedural techniques.
Is TAVR riskier than open heart surgery?
TAVR is often less risky than open heart surgery, especially for patients considered high-risk for conventional surgery. It has a shorter recovery time and fewer complications like bleeding and infection.
Can you do a TAVR twice?
Yes, TAVR can be performed to replace a previously implanted bioprosthetic valve (valve-in-valve procedure).
How common is heart block after TAVR?
Heart block requiring a pacemaker is a known complication, though the exact incidence varies.
Does the heart stop during TAVR?
No, the heart does not stop during TAVR. The procedure is typically performed under sedation or general anesthesia, with the heart beating normally.
Can TAVR last 20 years?
The long-term durability of TAVR valves beyond 15-20 years is still being evaluated. Most current data are promising, but longer-term studies are needed.
Does TAVR cause depression?
There’s no direct link between TAVR and depression. However, the overall health challenges and lifestyle changes associated with heart disease and post-operative recovery can impact mental health.