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Structural Heart Disease

Minimally invasive procedures like Transcatheter Aortic Valve Replacement (TAVR) offers heart patients the potential for less scarring, less blood loss, less pain, and a faster recovery.

Cardiac conditions relating to the heart valves, vessels, or walls are considered to be part of structural heart disease. While some structural heart conditions are congenital (present at birth), others may develop over time through wear and tear on the heart. They also may be caused by separate disease processes. Septal defects, valvular disease resulting in valve leakage or regurgitation, and aortic stenosis are examples of structural heart disease.

Surgical treatment is needed for structural heart disease. The latest cardiac innovations are minimally invasive procedures done in the cath lab. Minimally invasive surgery like TAVR (transcatheter aortic valve replacement) offers the potential for less scarring, less blood loss, less pain, and a faster recovery. More importantly, these groundbreaking cardiac procedures give hope to patients who are not able to have conventional open-heart surgery. 


Covenant Health was the first to bring TAVR to East Tennessee, and we continue to lead the region in TAVR cases. The first TAVR was performed at Parkwest Medical Center on June 6, 2012. Covenant Health has performed more than 750 TAVR procedures since that time. Our annual average of 70 cases per year is more than double the average of 30 cases per year at 223 other medical centers that participated in the PARTNER (Placement of Aortic Transcatheter) Valves Trial.


The TAVR Team

The Covenant Health TAVR physician team is made up of cardiologists, cardiothoracic surgeons and anesthesiologists from Parkwest Medical Center, Fort Sanders Regional Medical Center and Methodist Medical Center. 

The TAVR team also includes nurses and technicians with specialized training and a nurse navigator who provides education, a plan of care, emotional support, and guidance through the TAVR experience. The navigator also acts as a liaison between the medical team and the patient and family.

Even the operating room used for TAVR procedures is multidisciplinary in design. A unique surgical room known as a hybrid operating room combines the resources of a cardiac catheterization lab and an operating room, including the imaging equipment needed for minimally invasive procedures. 

Who Should Have TAVR?

The ideal TAVR candidate:

  • Has symptoms typical of severe aortic stenosis (shortness of breath, syncope and, in some cases, evidence of congestive heart failure)
  • Has undergone a Transthoracic Echocardiogram (TTE), with a mean gradient > 40mmHg or jet velocity greater than 4.0m/s or initial aortic valve area of < 0.8 cm2
  • Has not been responsive to noninvasive treatments
  • Is unable to tolerate traditional (through-the-sternum) surgery