TAVR (Transcatheter Aortic Valve Replacement)

What is TAVR?

Transcatheter aortic valve replacement is a procedure in which a new valve is placed inside the diseased aortic valve without removing the old one. The new valve is delivered through a thin tube, usually inserted through a blood vessel in the leg.

In simple terms, the TAVR procedure replaces a faulty heart valve without opening the chest, helping blood flow smoothly from the heart to the rest of the body.

Why is the TAVR Procedure Needed?

The aortic valve controls blood flow from the heart to the body. When this valve becomes narrowed or stiff, the heart must work harder to pump blood. TAVR treatment is recommended when symptoms become significant or when traditional surgery carries higher risk.

Common Reasons and Key Conditions Treated

• Severe aortic stenosis causing restricted blood flow.
• Breathlessness occurs during routine activities.
• Chest pain or pressure.
• The patient may experience episodes of dizziness or fainting.
• Heart failure related to valve disease.

Types of TAVR / Procedure Variations

TAVR can be performed using different access routes depending on patient anatomy and overall health. The heart team selects the safest and most suitable approach.

• Transfemoral TAVR: The valve is delivered through the femoral artery in the leg.
• Transapical TAVR: Access through a small incision in the chest.
• Transaortic TAVR: Direct access through the aorta.
• Subclavian or carotid access: Used when leg arteries are unsuitable.

Why Choose Manipal Hospitals for TAVR?

Manipal Hospitals offers comprehensive structural heart disease care led by cardiologists, cardiac surgeons, anaesthetists, and imaging specialists. Each TAVR case is carefully planned to ensure safety and long-term success.

• Experienced heart teams trained in advanced valve therapies.
• State-of-the-art cardiac catheterisation laboratories.
• Detailed pre-procedure imaging and planning.
• Minimally invasive approach with faster recovery.
• Dedicated care pathways for international patients.

Indications for TAVR

TAVR may be recommended when:

• Aortic stenosis is severe and symptomatic.
• Open-heart surgery carries moderate to high risk.
• The patient is elderly or has multiple medical conditions.
• Valve disease significantly affects daily activities.
• Heart function is declining due to valve narrowing.

Who Should Avoid or Delay TAVR?

Certain situations may require careful evaluation or alternative treatments.

• Mild or moderate aortic stenosis without symptoms.
• Active infection affecting the heart or bloodstream.
• Valve anatomy unsuitable for catheter-based replacement.
• Severe bleeding disorders.
• Life expectancy limited by non-cardiac illness.

Preparing for TAVR

• Detailed heart imaging, including echocardiography and CT scans.
• Assessment by a multidisciplinary heart team.
• Blood tests and kidney function evaluation.
• Review of medications, including blood thinners.
• Support for international patients with travel and accommodation planning.

What Happens During the TAVR Procedure?

The TAVR surgery is performed in a specialised cardiac lab under local or general anesthesia. A catheter carrying the new valve is guided to the heart and positioned within the diseased valve. Once expanded, the new valve begins working immediately.

Step-by-Step Breakdown

• Admission and final pre-procedure checks.
• Insertion of the catheter through the chosen access site.
• Guiding the valve to the heart using imaging.
• Positioning and deployment of the new valve.
• Assessment of valve function and blood flow.
• Removal of the catheter and closure of the access site.

Recovery After TAVR

Recovery after TAVR is typically faster than after open-heart surgery. Many patients begin walking within a day and experience quick improvements in their breathing and energy levels.

Hospital stays usually range from two to five days, followed by a gradual return to normal activities with guidance from the care team.

Risks & Complications

While TAVR is considered safe, possible risks include bleeding at the access site, irregular heart rhythms, stroke, infection, or valve leakage. These risks are minimised through careful patient selection and experienced heart teams.

Benefits of TAVR

• Minimally invasive alternative to open-heart surgery.
• Shorter hospital stay and faster recovery.
• Improved symptoms and quality of life.
• Reduced physical strain for elderly or high-risk patients.
• Immediate improvement in blood flow.

What is the Cost of TAVR at Manipal Hospitals?

The cost of TAVR depends on valve type, procedure complexity, investigations, and hospital stay. Manipal Hospitals offers advanced valve replacement procedures at costs that are significantly more affordable compared with many Western and Gulf countries, without compromising on quality or safety.

Personalised cost estimates are provided after a detailed clinical evaluation.

International Patient Support at Manipal Hospitals

International patients can access full-service, all-in-one support provided to each patient, from complete review of the patient's medical files all the way through assistance with planning travel arrangements (airfare), providing interpreters, providing temporary housing, and providing organized aftercare to help assure that the patient has a successful treatment experience.