Transcatheter Aortic Valve Replacement (TAVR)

An Innovative Treatment Option for Aortic Stenosis

Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure for patients with critical aortic stenosis being offered through Meridian CardioVascular Network at Jersey Shore University Medical Center. This option is giving new hope to patients who have been determined to be inoperable due to other co-existing medical conditions. Recently, the FDA has approved the use of TAVR for individuals who are at intermediate risk for open-heart surgery. This greatly expands the number of patients who can be treated with this less invasive procedure for aortic valve replacement.  

For most patients with severe aortic stenosis, the gold standard treatment is a surgical procedure known as Aortic Valve Replacement (AVR). Today at Jersey Shore University Medical Center, patients with severe AS who were once considered too high-risk for traditional surgery can now explore other treatment options with Transcatheter Aortic Valve Replacement (TAVR).

The multidisciplinary team at Jersey Shore explains their approach to performing the TAVR procedure in this video. Hear Nelson LaMarche, M.D., Renato Apolito, M.D., and Brook Dejene talk about how they are advancing this revolutionary procedure for people living in the region.


 


 

In November 2011, the FDA approved the Edwards SAPIEN Transcatheter Heart Valve as a therapeutic option for adult patients with severe aortic valve stenosis, who were formerly considered ineligible for open heart surgery or aortic valve replacement by a cardiac surgeon. TAVR enables the placement of a stent based tissue aortic heart valve into the body via a catheter that is inserted through a cut in the (groin) vs. leg and threaded up to the heart through the arteries.

TAVR is performed in a cardiac operating room or hybrid catheterization lab under general anesthesia. By combining minimally invasive techniques with the latest catheter technologies, TAVR is a non-surgical option that is less invasive than conventional surgery and is done while the heart remains pumping therefore eliminating the need for the heart-lung machine.

The Edwards SAPIEN™ valve is inserted with a catheterization through the leg. Once inserted, the catheter valve begins functioning immediately helping to direct blood flow into the heart. The valve’s position and performance is immediately evaluated by fluoroscopy and echocardiography.

Jersey Shore’s Multi-Disciplinary Heart Team & Training
As a regional leader in cardiovascular care, Jersey Shore University Medical Center, part of Meridian CardioVascular Network, is one of the first TAVR programs in New Jersey.

Our multi-disciplinary heart team provides the most complete, most coordinated care to ensure the best outcomes for patients undergoing TAVR. The partnership between cardiothoracic surgeons and cardiologists of the Valve Center at Jersey Shore establishes the core of the TAVR Heart Team.

Severe Aortic Stenosis
Aortic stenosis (AS) is a type of valve disease that mainly occurs in the elderly and is characterized by a narrowing of the aortic valve opening, increasing resistance to blood flow from the left ventricle to the aorta. While up to 1.5 million people in the U.S. suffer from aortic stenosis, approximately 500,000 within this group of patients suffer from severe aortic stenosis, and only half of those patients show symptoms of their condition being severe. Severe aortic stenosis usually occurs in patients older than 75 years of age.

Healthy Aortic Heart Valve

Stenotic or Calcified Aortic Heart Valve

Aortic Stenosis Disease Prevalence & Treatment
Cardiovascular disease is the number one cause of death, killing more than 600,000 Americans each year.

  • According to the American Heart Association, more than five million Americans are diagnosed with heart valve disease each year.
  • Heart valve disease can occur in any single valve or a combination of the four valves, but diseases of the aortic and mitral valves are the most common, affecting more than five percent of the population.
  • While up to 1.5 million people in the U.S. suffer from AS, approximately 500,000 within this group of patients suffer from severe AS. An estimated 250,000 patients with severe AS are symptomatic.
  • An echocardiogram (echo) is the primary imaging test used to diagnose severe AS.
  • Without an aortic valve replacement (AVR), 50 percent of patients will not survive more than an average of two years after the onset of symptoms.

Diagnosis of Severe Aortic Stenosis
Heart valve disease may be suspected if the heart sounds heard through a stethoscope are abnormal. This is usually the first step in diagnosing a heart valve disease. A characteristic heart murmur (abnormal sounds in the heart due to turbulent blood flow across the valve) can often indicate valve regurgitation or stenosis. To further define the type of valve disease and extent of the valve damage, physicians may use any of the following diagnostic procedures:

  • Electrocardiogram (ECG or EKG)- a test that records the electrical activity of the heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and detects heart muscle damage.
  • Echocardiogram (echo)- a noninvasive test that uses sound waves to produce a study of the motion of the heart's chambers and valves. The echo sound waves create an image on the monitor as an ultrasound transducer is passed over the heart.
  • Chest x-ray - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film. An x-ray can show enlargement in any area of the heart.
  • Cardiac catheterization - this diagnostic procedure involves a tiny, hollow tube (catheter) being inserted into an artery leading to the heart in order to image the heart and blood vessels. This procedure is helpful in determining the type and extent of valve blockage.
  • Magnetic resonance imaging (MRI)- a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

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