After Transcatheter Aortic Valve Replacement

Overview

We wish you a speedy recovery from your transcatheter aortic valve procedure.  Here is some important information for when you return home.

How long will I stay in the hospital after TAVR?

Many patients who have TAVR are able to go home the day of the procedure or the next day. If you have your TAVR procedure through a chest incision, you will stay in the hospital for several days after your procedure.

How will I feel after the TAVR procedure?

You will have some pain/discomfort at the incision site(s). Your nurse will keep track of your pain and help you get comfortable. You may still have some symptoms after the procedure. It may take a little time for symptoms to improve and disappear due to other medical problems you may have. Most patients have a better quality of life by their 30-day follow-up appointment and still better at their 6-month follow-up visit.

Transfemoral Groin Approach

Care for the procedure site

When you go home, there will be a bandage (dressing) over the catheter insertion site (also called the wound site).

• Wash your hands before you touch your incision site.
• The morning after your procedure, you may take the dressing off. The easiest way to do this is when you are showering, get the tape and dressing wet and remove it.
• After the bandage is removed, cover the area with a small adhesive bandage. It is normal for the catheter insertion site to be black and blue for a couple of days. The site may also be slightly swollen and pink, and there may be a small lump (about the size of a quarter) at the site.
• Wash the catheter insertion site at least once daily with soap and water. Place soapy water on your hand or washcloth and gently wash the insertion site; do not rub.
• Keep the area clean and dry, except when showering.
• Do not use creams, lotions or ointment on the wound site.
• Wear loose clothes and loose underwear.
• Do not take a bath, soak in any kind of water, or swim until the incision is completely healed

Activity

• Do not strain during bowel movements for 3 to 4 days after the procedure. This helps prevent bleeding from the catheter-insertion site.
• Do not lift anything that weighs more than 10 pounds or push or pull heavy objects for the first 5 to 7 days after the procedure.
• Do not do any strenuous activities for 5 days after the procedure. This includes most sports, such as jogging, golfing, playing tennis and bowling.
• You may climb stairs if needed, but walk up and down the stairs more slowly than usual.
• Gradually increase your activity level during the week after the procedure, when you should be back to your normal routine.
• Do not have sexual intercourse. Ask your doctor when it is safe to resume sexual activity.
• Do not drive until you get the OK from your doctor.
• Ask your doctor at your follow-up visit about taking part in Stage II cardiac rehabilitation.

Transapical or Transaortic Approach

It will take about 8 weeks for your sternum to completely heal. Please follow these instructions to help improve your recovery.

Care for the procedure site

• Wash the site at least once a day with soap and water. Do not use perfumed soap or shower gel. Put soap on your hand or a washcloth and gently cleanse and rinse the area. Do not rub the area.
• Wash your hands before you touch your incision.
• Keep the area clean and dry, except when showering.
• Do not use creams, lotions or ointment on the incision site.
• Do not take a bath, soak in any kind of water, or swim until the incision is completely healed.

Activity

• Do not lift anything that weighs more than 10 pounds for 8 weeks after your procedure.
• Do not drive until you get the OK from your doctor.
• Walk every day, and continue to increase your effort and length of time you walk.
• Do not do any strenuous activity before your doctor tells you it is okay to do so.
• Do not have sexual intercourse. Ask your doctor when it is safe to resume sexual activity.
• Ask your doctor at your follow-up visit about taking part in Stage II cardiac rehabilitation.

Additional Information

Importance of a Heart-Healthy Lifestyle

To get the best results from your TAVR procedure, you must commit to living a heart-healthy lifestyle. Your healthcare team can help you reach your goals, but it is up to you to take your medications as prescribed, make changes to your diet, quit smoking, get regular exercise, keep your follow-up appointments and be an active member of your treatment team.

Medications after your TAVR

• Please talk to your doctor about the medications you need to take when you go home. You may need to start taking new medications or stop taking some you took before your TAVR procedure. Make sure you know which medications you need to take and how often to take them.
• If you have diabetes, ask your doctor if you need to make any changes to your diabetes medications. Your doctor may adjust your diabetes medications for one to two days after your procedure.
• Antiplatelet medication. You will need to take a “baby aspirin” (81 mg) every day. And, for 30 days after your procedure, you may also need to take clopidogrel (Plavix) along with the aspirin or other blood thinner you may be taking. Please tell your cardiologist if you cannot take these medications or if you have recently had problems with bleeding.

Prevent Valve Infections

People who have valve replacements are at risk for developing infective endocarditis (IE), a deadly infection that affects the valves of the heart.

To prevent IE, you will need to take good care of your teeth and gums; take an antibiotic before you have certain procedures, such as surgery, invasive procedures, and some dental work; and treat infections promptly. Talk to your doctor about preventive antibiotics and the risk of infection.

Follow-up care

It is very important to make sure you follow-up with your healthcare providers after the TAVR procedure. Visits with your cardiologist should include:

• The first week after your procedure. If you are local or staying in Cleveland for a few days, we will see you at Cleveland Clinic. Otherwise you can see your local doctor at that time. 
• Within one month of the procedure. This visit should include an echocardiogram.
• Six months after the procedure
• One year after you get your new valve (or sooner, if your cardiologist recommends a sooner visit).

Frequently Asked Questions

How long will the new valve last?

The transcatheter heart valve is designed to work like a normal valve. It can last 10-15 years, but this can vary from patient to patient. Your valve will be checked at each follow-up visit using an ultrasound (echocardiogram) to make sure it is working as it should and to check for any problems or degeneration.

Can I have Magnetic Resonance Imaging (MRI) after I have the TAVR procedure?

Your new valve is surrounded by a metal stent. After your TAVR procedure, you will get a pocket ID card that has information about your valve. Please carry this card with you at all times and show it to your doctor, nurse or radiology technician before you have an MRI.

Before you leave the hospital you will be provided with a phone number and information if you have any questions or concerns once you are home.