Replacing an aortic valve in the weakest patients


Understanding Transcatheter Aortic Valve Replacement (TAVR)

What is it?

Transcatheter Aortic Valve Replacement (TAVR) is a procedure for select patients with severe symptomatic aortic stenosis — a narrowing of the aortic valve opening.

While open-heart aortic valve replacement surgery is the standard treatment for severe symptomatic aortic stenosis, there are patients who are not candidates for open surgery. These inoperable or extremely high-risk patients may be unable to undergo traditional surgery because of factors such as age, history of heart disease, frailty or other health issues.

For these patients, transcatheter aortic valve replacement, or TAVR, may be an option. The TAVR procedure allows physicians to replace a diseased aortic valve without open-heart surgery. This procedure enables the placement of a heart valve into the body with a catheter, which allows the valve to be inserted through a small incision into an artery.

How is it done?

The TAVR valve that will open and close to regulate the flow of blood is made of a bovine (cow) heart valve stitched inside of an expandable stainless steel scaffold, or stent.

During the TAVR procedure, the new valve is crimped down to the approximate diameter of a pencil and placed on a catheter. A small incision is made in the groin, and the catheter is fed through the femoral artery to the heart, much like an angioplasty procedure. Once in the heart chamber, the new valve is positioned directly inside the diseased aortic valve where the catheter balloon is inflated to secure the valve in place. The valve will begin to work immediately, functioning like a normal, healthy valve.

The TAVR procedure is performed under general anesthesia, in a hybrid operating room. A cardiothoracic surgeon, an interventional cardiologist and a clinic coordinator work together, utilizing fluoroscopy and echocardiography to guide the valve to the site of the patient's diseased heart valve.

The most exciting aspect of this procedure is that it provides hope when there were no previous options. The transcatheter valve offers some patients the potential of a longer life with better quality.

The TAVR procedure generally is performed in much less time than open-heart surgery. Additionally, open-heart surgery can require a two- to three-month recovery period, compared to the recovery period of only a few days with the transcatheter approach.

TAVR Criteria

Any patient diagnosed with severe aortic stenosis that is deemed inoperable for open aortic valve replacement can be referred by their cardiologist to Lee Health's structural heart program clinic for TAVR evaluation.

All potential candidates will be assessed and educated by our specially trained team, consisting of a cardiothoracic surgeon, an interventional cardiologist and a clinic coordinator. Together they will conduct a comprehensive evaluation to determine whether this procedure is an appropriate option for the patient.

If we find that you are a candidate for the TAVR procedure, you will be given specific instructions and scheduled for surgery at HealthPark Medical Center.

Risks

TAVR is a significant procedure typically requiring general anesthesia. While less invasive than openheart surgical aortic valve replacement, TAVR still has the potential for similar adverse effects, including risk of death, stroke, damage to the artery used for replacement of the valve, major bleeding, and other life-threatening and serious events. The components of the valve are made from similar material as those in a conventional aortic valve replacement.

Technology and expertise at Lee Health

HealthPark Medical Center became the first hospital in Florida—outside of clinical trials—to offer the minimally-invasive TAVR valve replacement procedure.

We are the only health system in Southwest Florida to offer this procedure to our patients.

Lee Health provides the most advanced valve replacement surgeries and treatments using a multidisciplinary approach. Our structural heart program regularly handles the most complex cases in the region with excellent outcomes.

Who to contact

If you are a referring physician and would like to more information about the TAVR procedure or the structural heart program at Lee Health, please contact us at:

Structural Heart Program
9981 S. HealthPark Drive, Suite 120
Fort Myers, FL 33908
Phone: 239-343-6341
Fax: 239-343-6342
Email: ShipleyCardio@LeeHealth.org

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