We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
JAMA Patient Page |

Transcatheter Aortic Valve Replacement FREE

Jill Jin, MD, MPH
JAMA. 2014;312(19):2059. doi:10.1001/jama.2014.15448.
Text Size: A A A
Published online

Transcatheter aortic valve replacement (TAVR) is a way to treat aortic stenosis.


The aortic valve is a 1-way gate between the largest chamber of the heart, the left ventricle, and the rest of the body. Sometimes, as people age, the aortic valve stops opening properly and does not let enough blood through. This condition is called aortic stenosis. Some people with aortic stenosis do not have any symptoms. But if the condition becomes severe enough, people will often have dizziness, fainting, trouble breathing, or chest pain.


When aortic stenosis is severe and causes symptoms, the best treatment is to replace the old aortic valve with a new one. This is called aortic valve replacement. The new aortic valve can be made from mechanical parts (mechanical valve) or from tissue from animals such as pigs or cows (tissue valve or bioprosthetic valve). Sometimes, donor valves from humans can also be used. Other options for treatment include repairing the old aortic valve or using medications to help with symptoms, but these are not as effective as aortic valve replacement.

The traditional method for aortic valve replacement has been open heart surgery, in which the sternum, the bone in front of the chest covering the heart, is opened up to get to the heart. During this process, the heart is stopped and a “bypass” machine keeps blood flowing through the body while a surgeon replaces the aortic valve. However, in some people who are older and have long-standing health problems, open heart surgery may be too risky because it would be unlikely that these patients would recover after surgery. These people are said to have high surgical risk.


In 2011, the US Food and Drug Administration approved a new type of procedure called transcatheter aortic valve replacement (TAVR) as an option for aortic valve replacement in people with high surgical risk. This procedure uses a catheter (a soft, flexible tube) to replace the old aortic valve with a new one by going through blood vessels to get to the heart instead of directly accessing the heart by opening up the chest wall. With TAVR, a catheter is inserted into the body through a small hole in the groin, neck, or over the chest between the ribs, and no large incision over the chest or heart bypass is needed. Therefore, it is a more gentle procedure on the body and a good option for people with high surgical risk.

Because TAVR is a fairly new procedure, studies are still being done to investigate the long-term outcomes. In early studies, patients with high surgical risk who have TAVR done instead of traditional open heart surgery for aortic valve replacement have a lower risk of death. However, there is also a higher risk of stroke with TAVR compared with open heart surgery. A team of heart specialists and surgeons usually decides which option, TAVR or open heart surgery, is best for people who need aortic valve replacement.

Box Section Ref ID

For More Information

To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA’s website at jama.com. Many are available in English and Spanish.


The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.

Source: Manning WJ. Asymptomatic aortic stenosis in the elderly: a clinical review. JAMA. 2013;310(14):1490-1497.

Topic: Cardiovascular Disease



Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Related Content

Customize your page view by dragging & repositioning the boxes below.

Related Collections