Comparing SAVR vs. TAVR
By ShareMD Connect
Understanding your treatment options for aortic stenosis can be overwhelming, but eventually, it’s likely that you’ll need surgery to correct your diseased valve. This means that you’ll likely need to consider two options: SAVR vs. TAVR.
What is SAVR?
SAVR, or Surgical Aortic Valve Replacement, is an open-heart procedure to replace your aortic valve. It’s what you typically think of as “open heart surgery.”
During the SAVR procedure, after you are put to sleep under general anesthesia, your surgeon with make an incision in your breastbone to open the chest cavity. Afterward, you will be placed on a heart-lung (bypass) machine, which allows the surgeon to stop your heart while the machine continues pumping blood and oxygen to your body. Next, your original aortic valve is removed and replaced with a new one. This new valve may be a mechanical (metal) or bioprosthetic valve (generally created from a cow or pig valve).
After your procedure, you’ll probably stay in the hospital for a little less than a week. Overall recovery from the surgery usually takes about 6-8 weeks.
SAVR is an invasive surgery but is the best choice for many people.
SAVR is usually recommended for those under 65 years old. However, age is not the only factor used to determine which procedure is right for you. Disease severity and your personal treatment goals are also important to consider.
What is TAVR?
TAVR or Transcatheter Aortic Valve Replacement (which used to be referred to as TAVI or Transcatheter Aortic Valve Implantation) has emerged as an alternative to open heart surgery for many people living with aortic stenosis.
The procedure was approved by the FDA more than ten years ago, and recent research shows that it has better outcomes than a SAVR procedure in those who are high risk and similar outcomes for those who are low risk to a SAVR procedure.
TAVR is a less invasive surgery. During the procedure, a surgeon will insert a catheter (usually through your groin) into your artery. The valve is folded inside the catheter to travel through your arteries until it reaches your heart.
Once the surgeon reaches your heart, they will unfold the bioprosthetic valve. As it expands (either by balloon or a self-expanding mechanism), the new valve will push the diseased valve to the side and secure itself to your heart. The surgeon then removes the catheter, tests it to ensure everything is functioning properly and closes the wound.
TAVR can be a great option regardless of if a person is or isn’t a good candidate for SAVR. It’s a breakthrough procedure for those who are too high risk for open heart surgery, but it’s revolutionary for everyone with aortic stenosis.
However, the American College of Cardiology highlights some of the limitations of TAVR. They include:
- There is usually a leak between the new and old valves. However, it’s rarely a cause for concern.
- Pushing the old valve to the side and leaving it in your body can cause wiring problems within your heart, which may require correction via a pacemaker.
- Because TAVR has only been studied in large numbers for about ten years, we don’t know as much about the long-term outcomes. There is a possibility that these valves will need to be replaced again down the road.
TAVR is something your physician should be discussing, either to tell you it’s an option or to explain why it isn’t. If your doctor hasn’t brought it up, that may be a sign that you need to seek a second opinion.
How to make your choice
Choosing between SAVR and TAVR can be overwhelming. The good news is that research has demonstrated a significant improvement in the overall quality of life in those that undergo surgical treatment, either by SAVR or TAVR.
Both have risks and benefits, so it’s important that you discuss the options with your provider.
You also have access to ShareMD nurses who can help you understand the differences between these two procedures. Our nurses have years of cardiology expertise and can answer your questions completely free of charge. No strings attached; our goal is to simply help you connect with the care you need.