What Is TAVR (Transcatheter Aortic Valve Replacement)?

The new valve starts its journey folded down inside a thin tube. It travels through a blood vessel, up into the heart, and only once it is sitting exactly where the old aortic valve sits does it open out and start work — the chest is never opened to get it there. That, in one picture, is TAVR: transcatheter aortic valve replacement, also called TAVI, for transcatheter aortic valve implantation. The video at the top of this page, "Transcatheter Aortic Valve Implantation" (about two and a quarter minutes), sums the idea up neatly: this minimally invasive procedure repairs the valve without removing the old, damaged valve — instead, it wedges a replacement valve into the aortic valve's place. Here is how that happens, step by step.

Step one — the work-up comes first

No one goes straight to a TAVR. It is a treatment for a narrowed aortic valve — aortic stenosis — where the valve that lets blood leave the heart has stiffened and no longer opens fully, so the heart has to push harder to move the same amount of blood; left severe and untreated, that extra strain is one road towards the symptoms covered in our guide to heart failure. Before any procedure, a specialist heart team confirms how narrow the valve really is and how the heart is coping. An ultrasound scan of the heart is central to that — our explainer on what an echocardiogram shows walks through it — and detailed imaging of the heart, the valve, and the blood vessels the catheter will travel through helps the team plan the route and the valve size. Whether TAVR, open surgery, or neither is the right answer is that team's judgement, made with you, and this article doesn't pretend to make it.

Step two — the catheter goes in

On the day, you are in a catheter laboratory or a hybrid operating room, with the imaging equipment that will guide everything that follows. You will have an anaesthetic or sedation — the exact choice is agreed in advance. The team makes a small opening into a blood vessel, most commonly the large artery in the groin, and threads a long, thin tube — the catheter — through it. Some patients need a different entry point, and that will have been decided at the planning stage, not improvised on the day. At the tip of the catheter, folded tightly down so it can travel, sits your replacement valve: tissue leaflets mounted inside a supporting frame.

Step three — the new valve is positioned and opened

Guided by live X-ray and ultrasound pictures, the catheter is steered up through the aorta until the folded valve sits inside your old aortic valve. This is the part the second video on this page, "Transcatheter aortic valve replacement (TAVR)", is describing when it frames TAVR as an option for severe aortic stenosis. Once the position is checked, the new valve is expanded. As it opens, it pushes the old, stiffened leaflets aside and takes their place — nothing is cut out and removed. The new leaflets then do the job the old ones no longer could: opening as blood leaves the heart, and closing to stop it flowing backwards. The team checks the new valve on imaging — including whether blood is leaking around its edges — before the catheter comes out; that checking habit, using pictures taken from inside the circulation, is the same principle behind a coronary angiogram.

Step four — the first days afterwards

With the catheter out, the entry site in the vessel is closed and you are monitored while you wake up properly. Most people sit up and start moving around far sooner than open-chest patients do, simply because there is no chest wound to recover from — but "smaller procedure" does not mean "no recovery". Expect checks of your heart rhythm, your blood pressure, and the puncture site, and an ultrasound scan to confirm the new valve is working as intended before you go home. Tiredness for a while afterwards is normal. A puncture site that becomes increasingly painful, swollen, or bruised, new breathlessness, chest pain, or feeling faint should always be reported promptly rather than waited out.

And then — living with the new valve

Follow-up is part of the treatment, not an optional extra. You will be seen again by the valve team, usually with repeat scans, so they can watch how the new valve performs over time. You will also be told exactly which medicines to take afterwards and for how long — follow that plan as given, and raise any problems with it at follow-up rather than quietly stopping something. Many people notice the change gradually: the breathlessness and exhaustion that a narrowed valve caused tend to ease as the heart no longer has to force blood through a tight opening. If those symptoms creep back months or years later, say so — the follow-up system only works if you use it.

References & further reading

• MedlinePlus — Transcatheter aortic valve replacement (Medical Encyclopedia): https://medlineplus.gov/ency/article/007684.htm
• MedlinePlus — Aortic valve surgery - minimally invasive (Medical Encyclopedia): https://medlineplus.gov/ency/article/007407.htm
• MedlinePlus — Heart Valve Diseases: https://medlineplus.gov/heartvalvediseases.html

MedicalVideos.com has published trusted medical videos since 2007. The site was founded by Dr. Mohamed Ibrahim, MD, PhD — physician-scientist.

Frequently Asked Questions

Is TAVR the same as TAVI?

Yes — they are two names for the same procedure. As the video at the top of this page explains, the surgery may be called a transcatheter aortic valve replacement (TAVR) or a transcatheter aortic valve implantation (TAVI).

Is the old valve taken out during TAVR?

No. The procedure repairs the valve without removing the old, damaged valve. The replacement valve is wedged into the aortic valve's place, pushing the old leaflets aside, and the new leaflets take over the work of opening and closing.

Where does the catheter go in?

Most commonly through the large artery in the groin, after a small opening is made into the vessel. Some patients need a different entry point, and that is decided during the planning stage by the heart team.

Will I need open-heart surgery as well?

TAVR is done through a catheter, without opening the chest, and without removing the old valve. Whether it is suitable in place of open surgery is a decision for a specialist heart team after full assessment — this article does not set out who qualifies.

What follow-up will I need afterwards?

Expect monitoring of your heart rhythm, blood pressure, and the catheter entry site, a scan to confirm the new valve is working before discharge, and further valve-team follow-up with repeat scans afterwards. You will also be given a specific medicines plan to follow at home.

This article is for general education only and is not medical advice. It does not replace consultation with a qualified clinician. Whether TAVR is appropriate for you can only be decided by your own specialist heart team after full assessment.

Dr. Mohamed Ibrahim, MD, PhD

Physician-scientist · Founder, MedicalVideos.com

Dr. Ibrahim founded MedicalVideos.com in 2007 to make medical and surgical education freely accessible to students, clinicians, and patients.

Last reviewed: 11/11/26