Transcatheter Aortic Valve Replacement

Aortic Valve Stenosis

Aortic valve stenosis occurs when the opening of the aortic valve becomes narrowed and the valve no longer opens fully with each heartbeat. The aortic valve is located between the left ventricle of the heart and the aorta, the largest artery in the body. Aortic stenosis becomes increasingly common with age, predominantly affecting those over the age of 65. When symptoms, such as shortness of breath or chest pain, develop from aortic stenosis, the average life expectancy is only 1-2 years, with a prognosis that is worse than most cancers if left untreated. Unfortunately, at least 1/3 of patients with aortic valve stenosis today are not receiving valve replacement, which is the only treatment that is effective for this condition. This is because many patients who have severe aortic valve stenosis might be too frail or too ill for conventional open heart surgery.

TAVR Procedure

Transcatheter aortic valve replacement (TAVR) is a new technology that provides a treatment option for many patients who previously had no other options or were at high risk for conventional open heart surgery.

With TAVR, physicians now have the ability to provide aortic valve replacement via minimally-invasive approaches, including percutaneous procedures (intervention without an incision), which provide outcomes that are as good, or sometimes better than, surgical valve replacement. Instead of opening the chest to reach the heart, the cardiac surgeons use small tubes, or catheters, to thread very small surgical tools to reach the heart. (Figure 1 and Figure 2)

Figure 1: Transcatheter aortic valve replacement (TAVR) using a transfemoral approach to the aortic valve. Image by Edwards Lifesciences (tm) LLC, Irvine, CA

Figure 2: Transcatheter aortic valve replacement (TAVR) using a transapical approach to the aortic valve. Image by Edwards Lifesciences (tm) LLC, Irvine, CA

The UNC Valve Clinic and TAVR

The UNC Valve Clinic in the UNC Center for Heart & Vascular Care is ideally suited to offer TAVR to patients. TAVR is most successful when the physicians are involved in a collaborative approach to patient care. The UNC Center for Heart & Vascular Care has brought together cardiac surgery, cardiology, interventional radiology, and vascular surgery all under one roof to provide the most comprehensive care possible. This multidisciplinary team at one of the world’s leading academic medical centers allows each member to contribute their individual knowledge, expertise, and resources to provide the best patient care.

The TAVR procedure, by definition, is multidisciplinary. Patients benefit greatly when they can be evaluated by a multidisciplinary team, who then together can decide on the best treatment option and provide the highest level of care. Patients are seen in our Valve Clinic by an interventional cardiologist, a cardiothoracic surgeon, and a nurse coordinator in order to provide seamless, convenient, and comprehensive care. (Figure 3) By pooling knowledge, expertise, and resources, all options are evaluated, allowing the physicians in the UNC Valve Clinic to provide the best patient care.


The UNC Valve Clinic is also well-equipped to drive the TAVR technology into the future. UNC is at the forefront of not just using the technology but developing and advancing the technology. As one of the world’s leading academic medical centers, the UNC School of Medicine and its clinical programs are centered around the absolute best patient care, supported by two pillars of strength underneath: education for our trainees and research to move this field forward.


John Vavalle, MD
Thomas Caranasos, MD
Michael Yeung, MD
Andy Kiser, MD
Cassie Ramm, RN, BSN, UNC TAVR Nurse Coordinator

Contact Us

Call the Heart & Vascular Center referral line at 866-862-4327 to find specialists, make an appointment or learn more about preventing heart disease.

Open Access is a new physician referral service, created by the UNC Center for Heart & Vascular Care, which coordinates all admissions and transfers through a single phone call and guarantees immediate acceptance for patients. Please contact us to learn more or call 866-862-4327.

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