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TAVR: Transcatheter Aortic Valve Replacement
Transcatheter aortic valve replacement, or TAVR, replaces a narrowed aortic valve without open-heart surgery. A new valve is guided through a blood vessel, usually in the groin, and opened inside the old one.
What it is
The aortic valve is the heart's main exit door. In aortic stenosis, the valve leaflets stiffen and thicken, so the opening narrows and the heart must push harder to move blood out to the body. Over time this can cause chest pressure, shortness of breath, tiredness, lightheadedness or fainting. Once severe aortic stenosis causes symptoms, medicines cannot open the valve. The valve has to be replaced. TAVR does this with a tissue valve on a collapsible metal frame, delivered on a thin tube (catheter) and expanded inside the diseased valve.
Who it may help
TAVR is used for people with severe aortic stenosis. It can also treat a surgical tissue valve that has worn out, a procedure called valve-in-valve TAVR. Whether TAVR or open surgery is the better choice depends on age, other health problems, the shape of the valve and blood vessels, and your own goals. That decision is made with a heart team that includes an interventional cardiologist and a cardiac surgeon. Testing usually includes an echocardiogram, a CT scan of the heart and blood vessels, and often a heart catheterization.
How it's done
TAVR takes place in a hybrid operating room or catheterization lab. Many patients receive sedation rather than full general anesthesia. Through a small puncture in the artery at the top of the leg, the team guides the new valve to the heart using X-ray and ultrasound, then opens it inside the old valve. The new valve starts working right away. The procedure often takes one to two hours. If the leg arteries are too small or diseased, other routes may be considered.
Recovery
Many patients walk the same day and go home the next day, though some need a longer stay. Most people return to light activity within days and avoid heavy lifting for about a week, or as their doctor directs. You will have follow-up visits and echocardiograms to check the valve, and you will usually take an antiplatelet or blood-thinning medicine for a period of time. Because you will have an artificial valve, tell your dentist; antibiotics are usually recommended before certain dental work.
Risks
TAVR is less invasive than open surgery, but it is still a major heart procedure. Possible risks include bleeding or injury to the blood vessel used for access, stroke, a slow heart rhythm that needs a permanent pacemaker, a leak around the new valve, kidney injury from X-ray dye, and infection. Rarely, damage to the heart requires emergency surgery, or the procedure results in death. Your team will explain how these risks apply to you.
Dr. Smith's experience
Dr. Smith completed a dedicated structural heart disease fellowship at the University of Alabama at Birmingham. Since joining Cardiovascular Institute of the South in 2023, he has been primary operator for more than 85 TAVR procedures, including valve-in-valve TAVR, among more than 180 structural heart procedures. He also performs balloon aortic valvuloplasty, which stretches a narrowed valve and can serve as a bridge to TAVR for selected patients. In 2025 he performed Baton Rouge General's first successful paravalvular leak closure, a catheter procedure that seals a leak around a previously placed valve.
Frequently asked questions
Is TAVR open-heart surgery?
No. TAVR is done through a catheter, usually placed in an artery at the top of the leg. The chest is not opened and the heart is not stopped.
How long does a TAVR valve last?
Tissue valves, whether placed by surgery or TAVR, can wear out over time. TAVR has been in wide use for more than a decade and long-term data continue to grow. If a TAVR valve wears out, options may include another catheter-based valve or surgery.
Am I too old for TAVR?
There is no single age cutoff. Many TAVR patients are in their 70s, 80s or older. The decision depends on your overall health, strength and goals, not age alone.
Will I need a pacemaker after TAVR?
Some patients do, because the new valve sits close to the heart's electrical wiring. The chance depends on the valve type and your existing heart rhythm. Your team checks your rhythm before and after the procedure.
What tests will I need before TAVR?
Most patients have an echocardiogram, a CT scan of the heart and blood vessels, blood work and often a heart catheterization. Some also need a dental check or lung tests.
Do I need a referral to be evaluated for TAVR?
Many patients are referred by their primary care doctor or cardiologist. Some insurance plans require a referral, so call the office to check your plan.
Ask about TAVR at Cardiovascular Institute of the South
Dr. Smith sees patients at CIS Baton Rouge, 8401 Picardy Avenue · (225) 308-0247, and CIS Zachary, 6550 Main Street, Suite 1000 · (225) 654-1559. Your primary care doctor or cardiologist can also send a referral.