Aortic Stenosis Treatment: TAVR - How It Is Done

(This video was recorded on September 12th, 2023)

He is Board Certified in Internal Medicine, Pulmonary Disease, Critical Care, and Sleep Medicine and an Associate Professor at the University of California, Riverside School of Medicine.

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Video Produced by Kyle Allred
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#aortic #stenosis #TAVR

[Mjln]

My 95-year-old mother had a TAVR. Within three days she was back home and going for a walk around the neighborhood. This procedure is miraculous. There is no way she would have survived open-heart surgery.

[chrismoore]

Got it, thanks, I see the Dr tomorrow! Doc C has it summed up perfectly. Heading to DC. Pray for me.

[suzannelooms]

Excellent review of the treatment, risks and key factors in choosing between alternatives. Thank you.

[MultiEviscerator]

Sadly my elderly Dad was talked into a TAVR by a local interventional cardiologist. This after I got two other specialists from a nationally respected hospital (to give a 2nd & 3rd opinion). They said clinically he needs it, but they wouldn't do it because of his age and comorbidities. They said he likely had a couple more years of life without it, so he should make the best of it rather than risk the procedure. He never made it out of the hospital.

[windsongshf]

Boy this video came at the right time! Interesting stuff. My older relative, 87 has Alzheimer's. I recently moved in to take care of him and he also has Aortic Stenosis. His primary doctor has been monitoring it the last few years and said this procedure could buy him a few more years. His cardiologist said he doesn't need it yet, but let me know it was an option down the line. However, when I mentioned it to his neurologist, she said at his age and his stage of Alzheimer's, it wasn't recommended. She told me the procedure, anesthesia, hospitalization and recovery could be very rough for him and could cause his brain to decline more quickly. "Buying him a few more years" would not necessarily buy him quality of life even if it went well because Alzheimer's is progressive and the later stages are pretty bad. I've seen it first hand and it can get very scary.

[brucebeck]

My mother had the TAVR procedure at Riverside Community Hospital. The famous Dr. Gregory Fontana was one of the three other cardiologists observing. The doctors proclaimed success!!!! Before leaving the hospital, within a couple days, she went into a coma and remained that way for five weeks till passing. I guess when they say TAVR has minimal recovery time what they really mean is that you only have a minimal time to or else you die.

[Vantasticviews]

This is such great news! I have a bicuspid aortic valve which is being monitored with ECHOs every couple of years. I had a repair of a coarctation of the aorta when I was a kid and was dreading the possible need down the road for having my sternum cracked wide open! Yippee!!

[sapelesteve]

Excellent review of aortic stenosis Doc! I have the opposite problem, aortic arch aneurysm!

[bobthrasher]

Mom was around 90 when she had her TAVR done. Mom had serious and worsening calcification of the aortic valve. Although it was successful with no obvious side-effects it really did not improve her quality of life. I thought it might improve breathlessness and provide her more energy but I cannot detect much difference. Perhaps the stenosis would have otherwise have taken her life by now but we really can't know that outside clinical trials. She is almost 96 now.

[johnbrion]

It is important to emphasize that for younger patients healthy enough to undergo open heart surgery TAVR may not be the best option. There is a question of valve longevity with TAVR compared to traditional open valve replacement. Younger patients should not only think about the next 5 years but the next 15 or 20. TAVR is less invasive but that does not mean it is not without risks. Many younger patients have been lead by cardiologists to think they can just get a TAVR and avoid a longer recovery when that is not the best long term option for them. It is a great surgery which has helped many who are too frail or deconditioned to tolerate an open procedure. But that doesn’t mean it’s the best choice for everyone.

[richhahn]

I had TAVR in 2019 right after it was approved under Medicare. I had been approved to have TAVR through a clinical trial, but when TAVR was approved for low risk patients, I was switched to Medicare.

I asked for minimal anesthesia and felt little pain until they were maneuvering the valve into place. The anesthesiologist just dialed anesthesia up a little and I was fine. I was completely conscious during the entire process (about 45 minutes( and felt I could have walked out of the operating room.

A few minutes in the recovery room and then to my room. That was the worst part. At night, someone came in about every 2 hours to perform some kind of test. The worst was when they got me out of bed to weigh me at 3 pm. The next day I told my surgeon I wanted to go home so I could get some sleep. He approved my release, so I just spent 1 night in hospital.

I have a couple of suggestions for guys. One is to ask for a condom type catheter instead of the one they insert. When I had my heart catheterization they used a hard catheter and it caused a lot of bleeding, so I got them to approve the condom catheter. I also had trouble urinating after the heart cath. Before the TAVR procedure I took a Flomax and a couple hours after the procedure I took another. This was preapproved by the doctor. So no bleeding and no urination problem after TAVR.

Follow their advice when you get home. I think I may have overdone it as I had some bleeding at the catheter insertion site several days after I got home. It healed on its own, so no harm done, but take it easy especially on lifting things. I'm right at 4 years and doing fine.

Don't worry about the valve. It is not going to come out. Do what the doctors recommend, but after a few weeks don't even think about the valve. Consider physical therapy. I went 1 time and I was already doing much more than physical therapy would have me do, so we agreed I probably didn't need it. But if you haven't been very active in the past, definitely consider going.

[Inkling]

The fine motor skills required of surgeons, particularly heart surgeons, utterly amaze me. I could never do any of this with my clumsy hands.

[Rene-uzeb]

3:12 so wth is tavr recommended for younger patients? I wonder if any of these surgeries last longer than 10 years, hence geriatrics

[carlosflar]

Requirements to perform:
- 1-2 year ANP masters degree
- Being buddies with the boss
- "Trust me bro, I've seen this done many times"

Moral compas not required

[tinabrewer]

Doctor, is there a procedure that can be done to loosen, or melt blockages, using something like radio waves, sound resonance, etc...is there any such method? Im supposing there might be a chance of it breaking apart and causing stroke. It's just an idea im asking about. Id like to know if it exists. I'm a triple bypass CABG Patient

[janirairizarry]

What about for younger persons? My nephew was born with this.... he now is 7 and the doctor said he would need the surgery when he gets to

[McD-jr]

I wonder if my mother got Alzheimer after the vaccines. Now that I read a lot about it, I think so.