Transcatheter Aortic Valve Replacement
Physicians Regional Healthcare System offers trans-catheter aortic valve replacements (TAVRs), the minimally-invasive, life-saving innovation that doesn't require opening up the chest for patients with critical aortic stenosis. Aortic stenosis is one of the most common and serious valve disease problems with more than 20% of older Americans having aortic stenosis.
Aortic stenosis is a type of valve disease caused by calcium deposits that eventually narrow and stiffen the valve. As it becomes more difficult to pump blood throughout the body, there is added stress and pressure on the heart, potentially causing congestive heart failure. This can lead to symptoms of chest discomfort, shortness of breath, leg swelling, fatigue, lightheadedness, syncope (fainting spells) and even sudden death.
The most common cause of aortic stenosis is degenerative (age-related calcium deposits). Other causes include congenital disorders (bicuspid aortic valve), infection on the heart valve or rheumatic fever. It is estimated that more than 1.5 million people have aortic stenosis in the United States and more than 500,000 patients have severe aortic stenosis.
People with aortic stenosis may have a "murmur" that can be detected during a regular doctor's visit and general physical examination. This may alert the physician to order an ultrasound (echocardiogram) of the heart. This ultrasound test most often provides images and information to confirm the presence of aortic stenosis.
Patients with severe symptomatic aortic stenosis have a 97% death rate at 3 to 5 years if left untreated. In general, 50% of patients will not be alive after 2 years from the onset of their symptoms. If left untreated, the prognosis of patients who have symptoms from their severe aortic stenosis is poor.
In 2019, the TAVR procedure was approved for all patients with severe aortic stenosis and/or who are experiencing symptoms that are too high risk for standard valve replacement surgery. The treatment for aortic stenosis is dependent on the severity of the condition, the symptoms being caused by it and the overall health of the patient. Most commonly, the treatment for people with severe aortic stenosis with symptoms is standard valve replacement surgery.
Patients have the ability to opt for a TAVR procedure, which involves a puncture typically in the groin area. The interventionist and surgeon insert a catheter the size of a pen into an artery and guide it to the heart to place the new valve, which is made from tissue from a cow. It's the same material used for valves in open heart surgery, but the TAVR valve is designed to expand inside the existing valve. With a TAVR procedure, the patient does not need the chest opened for surgery or to be put on a heart-lung (bypass) machine.
Benefits of TAVR can include shorter procedure and hospital stay times, relief of symptoms almost immediately, improved heart function, faster recovery and less medication. Patients quickly experience improved energy and easier breathing. Patients who undergo this procedure also experience a significant decrease in all-cause mortality compared to traditional valve surgery.
Currently, the FDA is allowing TAVI/TAVR to be done at hospitals with a high level of cardiac and heart surgery experience. The procedure is performed by a team of physicians including both cardiologists and heart surgeons.