by Kristen Dicker.
Transcatheter Aortic Valve Replacement (TAVR) is a minimally-invasive procedure performed collaboratively by interventional cardiologists and cardiac surgeons.
Typically, people who have aortic stenosis (narrowing) or malfunction of the aortic valve need open heart surgery to replace the damaged valve. A valve controls the passage of blood from the heart to the body. It prevents the blood from flowing backward. If a person has a damaged valve it may not open enough to allow an adequate amount of blood to flow forward and causes the heart to work harder to pump the blood in the right direction.
Although TAVR is new to the Quad Cities and has the benefit of reducing hospital stay and recovery time while decreasing the risk of infection, it is not for everyone. Only those who have been diagnosed with severe aortic stenosis and who cannot tolerate traditional open heart surgery are eligible for TAVR.
James D’Antonio, MD, an Interventional Cardiologist with YRMC PhysicianCare, states, “People who are ill with other medical problems who would be at the least moderate risk for bad outcomes from surgery, such as the elderly, those with poor kidney or lung function, or those who have had prior open heart surgery or prior valve replacement are examples of who would benefit the most from TAVR. Eligibility is well documented based on clinical trial data.”
Cardiac surgeons and interventional cardiologists decide together who is most eligible for the TAVR procedure.
“Historically, patients have been referred to Phoenix to have TAVR performed, so it is an important procedure to have in the Quad Cities area,” said Dr. D’Antonio. “This is because it offers another level of service that our patients can utilize if needed and keeps our patients in our community.”
Dr. D’Antonio said, “Many people will benefit and many people will qualify for treatment by TAVR. Local patients get care and follow up from local doctors. That’s the benefit.”
During the TAVR procedure, a replacement valve is inserted into the damaged aortic valve. The older valve is not removed; the new valve takes over the job of the older one.
TAVR is a minimally-invasive procedure so, under image-guidance, interventional cardiologists and cardiac surgeons can deliver a new valve through a catheter directly into the older valve by way of the the femoral artery in the groin, which is called the transfemoral approach.
“About 90 percent of the cases we do are transfemoral and about 10 percent are alternative access,” said Dr. D’Antonio.
The TAVR approach is not without complications and risks. Stroke and bleeding are important risk factors to consider; however, “the technology is getting better at a very rapid rate for the treatment of aortic valve stenosis and there are good options available to fit the individual needs of our patients,” added Dr. D’Antonio.
If you would like more information about Transcatheter Aortic Valve Replacement or are experiencing any of the signs of aortic stenosis, such as chest pain, fatigue during times of activity, shortness of breath during exertion or heart palpitations, please talk to your primary care physician or your heart specialist. If you need help finding a local physician or heart specialist, please contact the YRMC Physician Listing Service at (928) 771-5106 or online at www.yrmc.org/find-a-doctor.