When it comes to ailments of the heart, Aortic Stenosis (AS) is one of the most common diseases, especially when it comes to senior citizens. It occurs when the opening of the aortic valve gets narrowed. Through the right intervention, Aortic Stenosis can be tackled. But to do so, one needs to know what the ailment entails. 

As mentioned, Aortic Stenosis is a disease that is more likely to occur among the elderly. That is why, on the eve of Senior Citizens Day, Dr. Karun Behal (MD, DM – Cardiology), Senior Consultant – Cardiology, Fortis Mohali, held a live session online where the specialist shared some vital insights on the ailment and various interventions that can be used to surpass it. Read on to know these key pointers from the live session. 

To start with, what is Aortic Stenosis?

In aortic stenosis, the Aortic valve doesn’t open completely, restricting the blood flow from the left ventricle of the heart to the aorta and the rest of the body. It may also affect the pressure in the left atrium. 

The aortic valve has three leaflets, and it separates the aorta from the left ventricle. The main function of the aortic valve is to open and allow blood flow from the left ventricle of the heart to the aorta, through which blood flows to the rest of the body. It also prevents the backflow of blood from the aorta to the left ventricle. Aortic stenosis happens when the valve doesn’t open up completely, which in turn reduces or blocks the blood flow. Dr. Behal also mentioned that aortic stenosis is more prevalent in the elderly population.

How is Aortic Stenosis diagnosed?

Dr. Behal opined that to treat this condition, it is important to determine if the symptoms are mild, moderate, or severe. Depending on the severity of the condition, the right treatment method is suggested. 

Aortic stenosis can be diagnosed clinically, where your doctor will use a stethoscope to look out for heart murmurs that may suggest an aortic valve condition. The doctor may also run several tests such as Echocardiography, which uses sound waves to create images of your heart. Echocardiography can also show the doctor how blood flows through the heart valves, and if there is an interference in the blood flow. 

What are the symptoms of Aortic Stenosis that one needs to look out for?

Most cases of aortic stenosis are asymptomatic, or the symptoms are visible only during the later stages. Some of the most common symptoms of aortic stenosis are:

• Heaviness/pain in the chest while indulging in physical activities
• Shortness of breath
• Fatigue
• Dizziness
• Palpitations

If these above-mentioned symptoms are persistent, it is important to talk to your medical practitioner immediately to diagnose aortic stenosis.

How is Aortic Stenosis treated?

Initially, aortic stenosis was treated through medications such as pain killers, blood thinners, and medicines that kept cholesterol levels and blood pressure in check, but it did not work on people with severe aortic stenosis. But nowadays, with the advancements in the medical field, severe aortic stenosis can be treated. Some of the most common treatment methods for aortic stenosis are:

Surgical Aortic Valve Replacement (SAVR): Surgery is one of the most popular methods to treat aortic stenosis. This is usually done through an incision in the chest. People who have undergone surgery for aortic stenosis have a better survival rate. However, surgery may not be recommended to elderly patients with aortic stenosis as it may lead to several health complications.

Transcatheter Aortic Valve Replacement (TAVR): This is a less invasive procedure for those who are at a higher risk of complications from surgical aortic valve replacement. In this procedure, the damaged valve is replaced with a bioprosthetic valve. 

What are the advantages of TAVR?

TAVR is a huge advancement in the field of medical sciences in the past 15-20 years. Due to its less invasive nature, TAVR has replaced open-heart surgeries. At first, TAVR was recommended to only those patients who were unfit for surgery. An open heart surgery involves attaching a heart-lung bypass machine to the patient and opening the chest cavity, which may lead to several complications. Post-surgery, the patient would have to be under observation for 10-12 days, and the recovery would take about 1 – 2 months. 

However, with TAVR, the chances of complications are reduced, and the patient can be discharged within 2-3 days of the procedure. The rate of recovery is also faster compared to SAVR.  However, SAVR is cost-efficient in comparison to TAVR.

Many patients and caregivers who had joined in on the session had questions for Dr. Behal, especially on the long-term consequences of the ailment. Here are a few of them. 

Can Aortic Stenosis cause sudden death?

Yes, aortic stenosis can cause sudden death, as the symptoms are not visible in the earlier stages. The patients do not recognize the signs until the later stages, during which treatment might be difficult, which may lead to sudden heart failure. The patients need to be mindful of the early signs and approach the doctor immediately to run diagnostic tests.

Does mild Aortic Stenosis require surgery?

No. SAVR and TAVR are recommended for those who are diagnosed with severe aortic stenosis. Mild and moderate symptoms can be treated with medications. However, the patient must frequently follow up with the medical practitioner to ensure that the symptoms do not worsen.

How long does a TAVI valve last?

In SAVR, two different types of valves are used – biological valves and prosthetic valves. Biological valves are made of animal tissues and last for about 10-15 years, while prosthetic valves are made of metal and last for about 20-25 years.

In TAVR, biological valves are used, and they last for 10-15 years.

What is the survival rate in Aortic Stenosis patients?

Aortic stenosis can either be asymptomatic or symptomatic. If the patient is asymptomatic and responds well to stress tests and other diagnostic tests, the outlook is positive, almost equivalent to the normal healthy adult population.

However, if the symptoms are severe, the outlook is negative. At this stage, it is important to run tests such as echocardiography to determine the damage done to the valve, and the treatment must be administered immediately.

What is the minimum age to undergo TAVI?

Initially, people above the age of 65 – 70 are considered for TAVI. And it is advisable for everyone above 75 to only opt for TAVR as the procedure is less invasive.

Does TAVR have any side effects?

Though TAVR is less invasive as compared to SAVR, there are several risks and complications associated with the procedure:

• Internal bleeding
• Pain
• Stroke
• Arrhythmia, requiring pacemaker implantation
• Death

Who qualifies for the TAVR procedure?

TAVR is mostly recommended to patients who display severe symptoms. After being diagnosed with aortic stenosis, it is necessary to discuss with your heart surgeon about the advantages and disadvantages of SAVR and TAVR, to decide the right treatment method for you. Sometimes, TAVR is also recommended for patients with moderate symptoms.

While diseases like Aortic Stenosis are indeed common, leading a healthy lifestyle & timely intervention by your doctor can help go a long way in keeping the disease at bay!

There has been news of hope in recent years for the treatment of a common heart condition Aortic Stenosis, a procedure called transcatheter aortic valve replacement (TAVR). It was introduced in the mid-2000s since then as many as 400,000 patients across the world have had TAVR. According to the trials published in 2010, it was found that the TAVR procedure drastically reduced the risk of death among the inoperable patients. TAVR has been also found to be effective for patients with high and intermediate risk of serious complications from surgery or death. Whether or not you should undergo the procedure is entirely your doctor’s call, but even then, it is essential you know all that you can about the procedure.

What is TAVR used for? 

TAVR is designed to treat Aortic stenosis hence it is important to understand the condition. 

Aortic valve stenosis or aortic stenosis occurs due to narrowing of the aortic valve opening. It is one of the most common and serious valves disease problems. Aortic stenosis restricts the blood flow from the left ventricle to the aorta and also affects the pressure within the left atrium of the heart. Some people have stenosis due to a congenital heart defect called a bicuspid semilunar valve. During aging, this condition is developed commonly as calcium or scarring damages the valve and restricts the amount of blood flowing through.

Sometimes the left ventricle wall may show muscular thickening because the ventricle must have worked hard to pump blood through the narrow valve opening into the aorta. Appropriate treatment can help reverse or help slow down the progress of this disease.

Symptoms caused by Aortic Stenosis

Many people may not experience any symptoms until the amount of restricted blood flow becomes greatly reduced. Then the symptoms may include:

• Chest pain

• Difficulty in walking short distances

• Feeling dizzy or light-headed or even fainting

• Rapid, fluttering heartbeat

• Difficulty in sleeping or needing to sleep in the sitting posture

• Swollen ankles or feet

• Decline in energy levels 

It may be important that someone suffering from aortic stenosis may not experience any of these symptoms. But if you observe a decline in routine physical activities or significant fatigue, it’s worth a doctor’s visit to check for reduced heart function.

Treatment for aortic stenosis

Your doctor may suggest a couple of tests to confirm or rule out aortic stenosis. Tests also help determine the cause and severity of the condition.

The treatment of aortic stenosis depends upon how severe your condition is. For mild or moderate cases your doctor may keep a check on you. You will have to get regular check-ups and echocardiograms. Your doctor may encourage you to make changes to improve your overall health. It might include:

• Working on weight loss

• Switching to a healthier diet

• Managing your stress

• Quitting smoking

• Exercising, depending on your symptoms

For patients with severe stenosis, treatment options may include surgical semilunar valve replacement (SAVR) or transcatheter semilunar valve replacement (TAVR).

Surgical Aortic valve replacement (SAVR) or transcatheter Aortic valve replacement

Traditional treatment of Aortic stenosis- Open Heart Surgery 

Open heart surgery is considered a major operation. During an open-heart SAVR procedure, an incision is formed within the chest to access the heart during which the heart is stopped and blood is bypassed through a heart-lung machine. After which the diseased valve is removed and replaced with a replacement valve. SAVR has been the historical standard treatment for aortic stenosis for years.

For candidates who are suitable SAVR has given good outcomes to those patients. But the major drawback of SAVR is the long recovery period that generally requires five to seven days of hospitalization after surgery and more than six weeks for a full recovery. If the patient has too many medical conditions then it makes them unsuitable for SAVR. 

A non-surgical treatment- TAVR

TAVR is a minimally invasive procedure. For severe aortic stenosis patients who cannot withstand open-heart surgery, it is now the first line of therapy. Unlike a SAVR procedure which involves opening the chest to exchange a patient’s semilunar valve with a mechanical or tissue valve, the TAVR approach delivers a collapsible replacement valve via catheter. This process involves inserting a hollow tube (catheter) into your aortic valve through the blood vessels. Once the new valve is placed, the balloon on the catheter’s tip is inflated to park the valve in the desired position. Once it’s done, the catheter is then removed and the new valve now does the job of regulating the blood flow.Patients who go under TAVR recover quicker compared to SAVR patients which allows them to leave the hospital and start cardiac rehabilitation sooner and that can help improve the quality of life. It is performed under sedative medication without giving general anesthesia and in most cases, the procedure takes 90 minutes. 

The risks TAVR may present

TAVR has major benefits but it also has certain risks as it is a complicated procedure. The risks may include stroke, heart attack, bleeding, and the need for emergency surgery. The risks are low but there is also potential damage to the electrical system of the heart which may result in the need for the placement of a permanent pacemaker. 

 Is TAVR right for everyone? 

Although it might seem like an obvious choice compared to the stress of open-heart surgery, a detailed review must come first because not everyone needs to undergo a TAVR procedure. All patients with severe aortic stenosis must be carefully evaluated to make the best choice for them. Patients in the high-risk category are usually likely candidates of TAVR. A potential patient must have severe aortic stenosis and a three-leaflet valve versus a two-leaflet valve. Patients who have an infection of the heart or associated aneurysms are also not advised for TAVR.

SAVR remains the preferred method for many patients, the surgical techniques have evolved and the valve technology has proven durability. Both the valves are tissue valves, the SAVR valve may be a fixed stent with an approximate lifetime of 15 years while as per The University of Texas Southwestern Medical Center TAVR valve which expands and contracts also has a lifespan of around 10 to 15 years.

If you think you have aortic stenosis, visit your doctor as soon as possible to minimize risks. Take a family member along with you for support and discuss all the options with your doctor. It is important to be evaluated by a heart team, which includes a clinical cardiologist, interventional cardiologist, and a cardiac surgeon. The team will review all your medical information and will provide you the treatment option that’s best for you along with the risks and benefits of the option. 

The possibility of having heart disease or a heart valve condition is overwhelming and frightening for most people. That is why having an understanding of heart diseases is important so that one can be well equipped with the right information, and hence take the right steps towards treatment.

Heart valve conditions are usually due to birth defects or age-related issues. Many heart valve conditions can be first identified with the help of a murmur, that is a whoosing sound as blood flows from one chamber to the next, or it may sound like an extra click when a valve allows backflow.

A murmur may indicate conditions such as Aortic stenosis, prolapse, regurgitation, etc. While medicines can be prescribed for a heart valve condition, they are mainly for the following reasons

• To reduce unpleasant symptoms from milder forms of the disorder.
• To maintain heart rhythm if a related arrhythmia is present.
• To lower the patient’s risk for clotting and stroke.

Valve diseases are generally progressive by nature, and the outlook for those who do not receive adequate and timely treatment could be fatal. If you are suffering from an aortic valve disease it is highly advisable to opt for a surgical procedure for low surgical risk patients.

The heart has four chambers. The two upper chambers are called the left and right atrium and the lower chambers are called the left and right ventricle. The four valves that are at the exit of each chamber carry out the function of continuous blood flow through the heart to the lungs and the rest of the body. The four valves are the tricuspid valve, pulmonary valve, mitral valve, and aortic valve.

The aortic valve controls blood flow from the left ventricle into the aorta (the main artery in your body). When this valve opens, the oxygen-rich blood is pumped to the aorta and then to the rest of the body. It is key to the body’s blood circulation system.

Reasons you might need to undergo heart valve surgery

Types of aortic valve disease that may require treatment with aortic valve repair or replacement include the following:

Congenital heart disease: This condition may contribute to other complications that prevent the aortic valve from operating properly. For instance, a person may be born with a condition where the aortic valve does not have enough tissue flaps (cusps) or with a valve that is the wrong size or shape, or without an opening that allows blood to flow normally.

Aortic valve stenosis: When the aortic valve becomes narrow or obstructed, it becomes difficult for the heart to pump blood into the aorta. This may be caused by the thickening of the valve’s closure flaps, congenital heart disease or post-inflammatory changes associated with rheumatic heart disease. Around 75% of patients with unoperated aortic stenosis may die 3 years after the onset of symptoms.

Bicuspid aortic valve: A birth defect where only two cusps grow instead of the normal three. This is a common cause of aortic stenosis. Another cause may be that the valve opening does not grow as the heart does. This makes it harder for the heart to pump blood to the restricted opening. The defective valve becomes narrow and stiff over time because of a calcium build-up. Age-related Aortic Stenosis usually begins after age 60, but often doesn’t show symptoms until ages 70 or 80.

Aortic valve regurgitation: When the blood flows backward through the aortic valve into the left ventricle each time the ventricle relaxes rather than in the normal one-way direction from the ventricle to the aorta. This may be caused due to an abnormal valve shape present at birth (congenital heart disease) or by a bacterial infection.

Most symptomatic patients of AR will require valve replacement surgery within 2 to 3 years of developing breathlessness and symptoms of heart failure. A Swedish study has proven that these individuals have a life expectancy of 2 years lesser than the healthy population of the same age.

Valve diseases, although gradual and progressive are fatal if not treated in the right manner. Valve replacement surgery is recommended as it helps alleviate your symptoms and add quality years to your life.

Careful monitoring and doctor supervision may be all that is needed for a few people with mild aortic valve disease without symptoms. However, in most cases, aortic valve disease and dysfunction can get worse.

Such conditions eventually require surgery to reduce the risk of complications such as heart failure, heart attack, or a stroke or death by cardiac arrest. This is when a doctor will recommend heart surgery.

What are the consequences of not having a heart valve surgery?

• Decreased life expectancy and quality of life

As per an estimate, as the aortic valve disease gradually worsens, the average rate of survival without undergoing surgery is a mere 50% post 2 years, while it is 20% post 5 years.

While you may feel normal and not notice any problems for years, valve disease is not a condition to be ignored. Once you begin to experience symptoms like the ones mentioned above, not only does life expectancy and quality of life decline but the severity of diseases such as aortic heart stenosis increases.

• Contributes to more health complications

As the wall of the left ventricle works harder to pump blood through the narrow valve

opening into the aorta, the wall might show muscular thickening, along with the symptoms of aortic stenosis like fatigue and weakness.

The thickened wall allows less room for an adequate amount of blood circulated to the body, as it takes up more space inside the lower heart chamber. This may cause heart failure.

It is advisable to undergo valve replacement surgery as it not only adds to a better quality of life and solves the issue of aortic stenosis but also helps avoid the consequential conditions that come along with it.

Coping with Aortic Stenosis can not only be stressful physically but also mentally. Learning about your condition and the right treatment by talking to your doctor about it can help a great deal. Aortic Stenosis can be fatal and not undergoing the right treatment or prescribed surgery can lead to not just a deterioration in your condition but also create newer complicated conditions for your health. Knowing and understanding your condition as well as the benefits and success rates of the treatment gives you an upper hand and a better chance at survival.

Disclaimer: This blog is only for awareness purposes. We do not intent to promote any medications given in the blog. Please consult your physician before taking any medication.

The human heart has four chambers, with the upper chambers being the left and right atrium and the lower chambers being the left and right ventricles. The heart valves are present at the end of each chamber and they maintain the one-way blood flow from the heart to the lungs and the rest of the body. The four different valves are – Pulmonary Valve, Tricuspid Valve, Aortic Valve and Mitral Valve.

The tricuspid valve is placed between the right atrium and right ventricle. Through this valve, blood flows to the right ventricle. The function of the pulmonary valve is to control the flow of blood between the right ventricle and the lungs. The mitral valve is positioned between the left atrium and left ventricle and allows the blood to flow between them. The aortic valve controls the blood flow from the left ventricle to the aorta. The aorta is the main artery of the body, from which blood flows to the other parts of the body.

What are Valvular Diseases?

Valvular diseases, commonly known as heart valve diseases, occur when one or more of the heart valves do not open or close properly, affecting the blood flow. When more than one valve is affected, it is known as Multiple Valvular Heart Disease. The different types of valvular diseases are:

Stenosis:

In this condition, the heart valves stiffen, leading to the narrowing of the valves. This in turn restricts the blood flow from the valves to the other organs. It keeps the valve from opening fully to allow smooth blood flow, due to which an inadequate amount of blood is supplied to the body. In severe cases, the valve opening may completely close, due to which the blood flow is blocked.

• Tricuspid valve stenosis: In this condition, the blood is unable to flow from the right atrium to the right ventricle, causing the atrium to enlarge. This affects the blood pressure and flows in the surrounding chambers. It can also cause the right ventricle to shrink or become smaller, restricting the blood circulation to the lungs.
• Pulmonary valve stenosis: If the pulmonary valve narrows, the blood flow from the right ventricle to the lungs is restricted, due to which oxygen-rich blood cannot be pumped to the rest of the body. In this condition, the right ventricle might have to compensate by pumping blood harder through the narrowed valve, increasing the pressure on the heart.
• Mitral valve stenosis: In this condition, the blood flow from the left atrium to the left ventricle is reduced, causing fatigue and shortness of breath. It may also cause enlargement of the atrium and fluid build-up in the lungs.
• Aortic valve stenosis: This is one of the most common heart conditions. In this condition, the blood flow from the heart to the aorta and the rest of the body is restricted. Due to this, the left ventricle has to pump harder to ensure blood flow to the aortic valve. This may also lead to the thickening of the left ventricle.

Prolapse:

Valvular prolapse is a condition in which the valve flaps slip out of place or bulge. This can lead to the valves being unable to close properly. Due to this, blood may flow backwards through the half-closed valve, disrupting the one-way blood flow.

• Mitral valve prolapse: Also known as Barlow’s syndrome, click-murmur syndrome and floppy-valve syndrome, this condition prevents the valve from closing evenly. The mitral valves may also bulge upwards into the atrium when the two ventricles contracts. Due to this, a small amount of blood may flow backwards through the valve.
• Tricuspid, Pulmonary and Aortic valve prolapse: These prolapses are less common as compared to Mitral valve prolapse. In the above-mentioned conditions, the leaflets/flaps of the valves do not close properly to form a tight seal.

Regurgitation:

Regurgitation happens when the valve doesn’t close properly, allowing the blood to flow backwards. This disrupts the one-way blood flow and puts a strain on the heart. This reduces the efficiency of the heart in pumping oxygen-rich blood to the rest of the body.

• Tricuspid valve regurgitation: In this condition, the blood pumped from the right ventricle to the lungs may flow back to the right atrium, leading to the enlargement of the atrium.
• Pulmonary valve regurgitation: In pulmonary valve regurgitation, the pulmonary valve doesn’t close properly, leading to the blood flowing backwards from the lungs to the heart. This backward blood flow may cause oxygen-rich blood to blend with oxygen-poor blood, reducing the availability of oxygen-rich blood to the rest of the body.
• Mitral valve regurgitation: Mitral valve regurgitation can be a result of mitral valve prolapse. In this condition, blood leaks backwards into the left atrium through the mitral valve. In severe cases, this condition may lead to the enlargement of the atrium and lung congestion.
• Aortic valve regurgitation: In this condition, blood leaks backwards from the aorta to the left ventricle, due to which the body does not get an adequate amount of blood, leading to the heart pumping harder to compensate. This may cause the thickening of the left ventricle.

Symptoms of Valvular Heart Diseases:

Some common symptoms of heart valve diseases are:

• Discomfort or tightness in the chest.
• Palpitations are a common symptom of heart valve diseases, which may cause the heart to enlarge, leading to irregular heartbeats (arrhythmia).
• Shortness of breath – as valvular diseases disrupt the flow of oxygen-rich blood to the body, causing breathlessness.
• Fatigue and weakness
• Dizziness and fainting
• Swelling occurs when the blood flows backwards, leading to fluid buildup and congestion, which in turn leads to swollen abdomen and feet.

Though the symptoms may slightly vary for different valvular diseases, it is important to be mindful of them and connect with your doctor even if you experience the mildest of symptoms. Though severe conditions may require surgical procedures, a few lifestyle changes will help keep these heart valve conditions at bay. Be aware and take precautions!

As we move ahead in life, it’s not just our lifestyles that change – the amount of pressure we put on our hearts increases as well. The increased strain at times gives way to various heart diseases, one of the most common ones among them being Aortic Valve Stenosis.

Aortic Valve Stenosis is a condition of the heart where one of the four valves i.e. the aortic valve is narrowed and fails to open properly. This causes various cardiovascular diseases due to inadequate blood supply and pressure on the aortic valve. To treat the said condition, a procedure called Transcatheter Aortic Valve Replacement (TAVR) is performed.

What is a TAVR Procedure?

TAVR is a minimally invasive medical procedure that is used to treat Aortic Stenosis (AS). Before TAVR, Surgical Aortic Valve Replacement (SAVR) or open-heart surgery was the only way to cure aortic stenosis, but the procedure also led to several other complications among patients. But TAVR has made this procedure Less painful, less scarring with a faster recovery.

As this approach avoids surgically opening the chest or making an incision on the heart, TAVR is a  safer option for high-risk patients. Before deciding on undergoing TAVR, you must consult your cardiac surgeon and specialists to determine if the procedure is beneficial for you. 

Why does Aortic Valve Stenosis need to be treated?

A few of the complications that arise with Aortic Stenosis are chest pain, extreme fatigue, fainting, gasping, and swelling on the leg. It may also lead to cardiac arrest and heart failure. Hence, it must be treated immediately.

What has involved in the Transcatheter Aortic Valve Replacement (TAVR) procedure?

A catheter, which is a small, flexible tube is used to place a new valve in the heart. The doctor will make a small incision in a blood vessel in your leg or the chest wall. Once done, the doctor uses advanced imaging techniques to guide the catheter to your heart and into the aortic valve and position it properly.

What are the different types of TAVR Procedures?

While TAVR is essentially the placing of a valve via a catheter, the procedure varies from case to case. These include –

Transfemoral TAVR: A small opening is made to access an artery in the groin area at the top of the leg.

Transapical TAVR: An incision is made in the chest wall, between the left ribs, through which the catheter is inserted.

Transaortic TAVR: A small opening is made on top of the breast bone, through which the catheter is directly inserted into the aorta. 

Transcaval TAVR: An incision is made in a large vein in the groin area, through which the catheter can be inserted, from which it goes through the vena cava to the abdominal aorta, and into the aortic valve. 

Why can’t all Patients with Aortic Valve Disease opt for a Transcatheter Aortic Valve Replacement (TAVR) procedure?

One can opt for TAVR if they have Aortic Stenosis that leads to other symptoms and complications. They can usually opt for TAVR if they are at a higher risk of experiencing complications from open-heart surgery. Open-heart surgery is also risky if one has a kidney or lung disease. Though TAVR might be preferred due to its minimally invasive nature, one must be thoroughly evaluated before undergoing a TAVR. Patients with extremely high risk to moderate risk conditions are usually the ideal candidates for TAVR. Similarly, patients with active endocarditis infection or a similar aneurysm also cannot opt for a TAVR. Bicuspid patients who don’t prefer an open-heart surgery can seek a thorough evaluation with the TAVR team to discuss the risk factors and benefits and to also seek other treatment options. Also, patients in their 50s and 60s are refrained from opting for TAVR due to limited data present for the durability of bioprosthetic heart valves.

Are there any risks involved in a TAVR procedure?

Every medical procedure comes with some risks and the same applies to TAVR too. Hence it is important to have an expert opinion before undergoing any surgery for Aortic Valve diseases. Some of the major risks involved in TAVR are as follows:

Bleeding: Though the procedure is minimally invasive, it involves inserting a catheter in your leg, which may lead to internal bleeding.

Complications in the blood vessels: Injuries are caused due to vascular access which in turn, can lead to tissue malperfusion. Passing catheters through the arteries can also damage them. 

Replacement valve: It might also lead to problems with the replacement valve such as blood leaks around the new valve or the valve slipping out of place.

Arrhythmia: It might lead to irregular heart rhythms, which would require pacemaker implantation.

Stroke: A small percentage of patients undergoing TAVR have complained of stroke, either during the procedure or after it. 

Damage to the kidney: The dye that is used for imaging can affect the kidneys, leading to kidney damage. But this complication is usually reversible.

Heart Attack: A minimal percentage of patients have also had heart attacks during the procedure.

Infection: Passing catheters through the arteries can also lead to infections, but they are usually treatable.

Death: While TAVR is usually effective, there is a very low possibility that the patient cannot survive the procedure. 

When it comes to heart health, it is important to weigh the pros and cons properly to avoid health issues in the future. As technology advances, the risks associated with it grows. But proper medical care and procedure surely avert all the risks and helps people to lead a normal life after TAVR or any surgery. All you need to do is take proper precautions and follow the advice of your doctor in the pre and post phases of the surgery to keep your heart healthy in the long run.