ST. LOUIS – Heart specialists at Saint Louis University Hospital have a new option for patients with aortic valve stenosis that allows patients at higher-risk for surgical valve replacement to achieve similar benefits without an open surgical procedure– transcatheter aortic valve replacement (TAVR).
For the millions of patients with aortic stenosis – the most common form of valvular heart disease in the U.S. – TAVR has been proven to not only improve quality of life, but significantly prolong one’s life following the procedure.
“TAVR is considered one of the most significant advancements in cardiovascular care over the past decade,” says Richard Lee, MD, co-director of the Center for Comprehensive Cardiovascular Care (C4) at SLU Hospital and a SLUCare cardiac surgeon. “It is a game changer.”
TAVR was approved by the U.S. Food and Drug Administration (FDA) for the treatment of severe, symptomatic aortic stenosis and inoperable status in 2011 and high-risk but operable status in 2012.
Aortic stenosis occurs when the valve narrows, preventing the valve from opening fully, obstructing blood flow. Left untreated, patients with symptoms of shortness of breath, chest pain/pressure, or passing out are known to have a shortened life-expectancy. To restore blood flow and prolong life, a new valve is necessary.
“A new valve can be complicated for some patients who may be too frail to undergo surgery,” saysMichael Lim, MD, co-director of the C4 and SLUCare cardiology director. “This is an important option that allows similar benefits but avoids an open surgical valve replacement.”
With TAVR, the procedure is performed by inserting the new valve through a catheter that can be inserted through the arteries in the leg. The new valve is guided into the old, diseased valve and opened up , “replacing” the narrowed valve with a new, instantly functional, tissue prosthetic valve.
Traditionally, the surgical option is an open procedure where a surgeon opens the chest with a sternotomy leading to a lengthier hospital stay.
In the first major trial investigating the efficacy of the TAVR procedure – the “PARTNER Trial” – TAVR “as compared with standard therapy, significantly reduced the rates of death from any cause.”
“Being able to offer TAVR as part of our treatment choices for some patients allows us to provide every possible option for all patients with valvular heart disease – a truly ‘comprehensive’ way to offer patients and their families options that are best suited for them,” says Dr. Lim.
Through the opening of a new hybrid cardiac catheterization lab at SLU Hospital, Drs. Lee and Lim are able to partner on not only TAVR, but another catheter-based treatment for patients with “leaking” of their mitral valve (mitral regurgitation) called the MitraClip.
Like all medical procedures, TAVR does come with some risk. For more information about TAVR at Saint Louis University Hospital, call 855-97-HEART.
