TAVR is a minimally invasive procedure that replaces a diseased aortic valve without open-heart surgery. A new valve is delivered through a catheter — typically inserted through a small puncture in the leg artery — and positioned inside the old valve, where it immediately begins to function.
Transcatheter aortic valve replacement (TAVR), also known as TAVI (transcatheter aortic valve implantation), is a catheter-based procedure to treat a severely diseased aortic valve. Instead of removing the old valve through open-heart surgery, the interventional cardiologist threads a new valve through a blood vessel — most commonly the femoral artery in the groin — and deploys it within the existing valve. The new valve pushes the old, calcified leaflets aside and takes over immediately.
TAVR was initially developed for patients who were too high-risk for traditional surgery. Over the past decade, landmark clinical trials (including the PARTNER and CoreValve/Evolut programs) have demonstrated excellent outcomes across the full spectrum of surgical risk — and TAVR is now performed in patients at all risk levels.
TAVR is FDA-approved for patients with severe symptomatic aortic stenosis across all surgical risk categories. Candidacy is determined by a multidisciplinary heart team and depends on anatomy (suitability of the femoral arteries and aortic valve), symptoms, overall health, and patient preference.
Emerging indications include aortic regurgitation. The JenaValve Trilogy system is the first transcatheter valve designed specifically for both aortic stenosis and aortic regurgitation — studied in the ALIGN-AR trial — and represents an important advance for patients with AR who are at high surgical risk.
Historically, aortic regurgitation (a leaking aortic valve) could only be treated with open-heart surgery. Newer purpose-built valve systems are changing this — offering a catheter-based option for high-risk AR patients for the first time.
TAVR is typically performed in a specialized cardiac catheterization laboratory or hybrid operating room. The patient receives conscious sedation or general anesthesia depending on the approach and clinical situation.
A small incision (or puncture) is made in the groin to access the femoral artery. A delivery catheter carrying a compressed replacement valve is advanced through the artery, up through the aorta, and positioned within the diseased native valve. Using fluoroscopy (real-time X-ray) and echocardiographic guidance, the valve is expanded — either by inflating a balloon or by self-expansion — locking it into place. The new valve begins working immediately, and the delivery system is removed. The access site in the groin is sealed using closure devices.
The entire procedure typically takes 60 to 90 minutes. Many patients are walking the same day and discharged from the hospital within 1 to 3 days.
Like any heart procedure, TAVR carries risks. These include vascular access complications (bleeding or injury at the groin site), stroke, need for a permanent pacemaker (due to the valve's proximity to the heart's electrical system), paravalvular leak (small amount of blood flow around the new valve), and, rarely, valve migration or need for a second procedure. Your heart team will discuss your individual risk profile in detail.
Most patients experience a significant improvement in symptoms — especially shortness of breath and fatigue — within days to weeks after the procedure. Regular follow-up with echocardiography is important to monitor valve function. Patients typically take blood-thinning medications for a period after the procedure and continue with routine cardiovascular risk factor management.