Submitted by OSF Saint Francis Medical Center
Life-saving treatment expanded
There’s good news for those suffering from severe aortic stenosis. The U.S. Food and Drug Administration (FDA) recently expanded approval of a life-saving heart valve replacement procedure for intermediate and high-risk surgical candidates. Previously, the Transcatheter Aortic Valve Replacement (TAVR) procedure was reserved for those too ill to undergo open heart surgery, but the FDA’s new designation means more patients will get the new heart valve they need without invasive surgery.
Why TAVR?
The TAVR procedure was designed to treat patients with severe aortic stenosis. The condition is a narrowing of the aortic valve opening that does not allow normal blood flow. While there are several factors than can cause aortic stenosis, the risks associated with it tend to increase with age.
In elderly patients, severe aortic stenosis is sometimes caused by the build-up of calcium on the aortic valve’s leaflets. Over time, the leaflets become stiff, reducing their ability to fully open and close. When the leaflets don’t fully open, your heart must work harder to push blood through the aortic valve to your body.
Eventually, the heart gets weaker and increases the risk of heart failure. Severe aortic stenosis is a serious health issue. Without treatment, half of the people who feel sick have an average life expectancy of two years.
The TAVR procedure is performed through a pinhole in the groin artery with no skin cut, or through the side of the chest using a catheter to transport a balloon-expandable heart valve and placing it in the damaged valve. The TAVR valve is a bovine (cow) valve that is mounted on a stent, and a balloon expands inside the old, unhealthy valve. The TAVR procedure is designed to replace a patient’s diseased aortic valve without the use of a heart-lung machine.
“The TAVR procedure allows us to replace the diseased valve while the patient’s heart is still beating,” said Dr. Sudhir Mungee, a lead physician on the TAVR team at HeartCare Midwest. “The procedure is similar to placing a stent in an artery. It provides immediate relief for our patients without the added risks associated with open-heart surgery.”
Who wins?
Under the new FDA guidelines, the procedure is available to patients who are at intermediate risk for death or complications associated with open-heart surgery. The procedure was previously only approved in patients at high or greater risk for death or complications during surgery.
While up to 1.5 million people in the U.S. suffer from aortic stenosis, approximately one-third of this group suffer from severe aortic stenosis. The new guidelines will make it easier for those patients to get the new heart valve they need, without the need for invasive surgery.
TAVR Benefits
The less invasive TAVR procedure is not as hard on the patient and offers a faster recovery time. Most patients will leave the hospital in an average of two to three days, and can resume all normal activities within 10 days of the procedure. In comparison, traditional open-chest surgery patients need up to seven days of hospitalization and six weeks of rehabilitation.
While there are risks to any type of surgery and individual results can vary, TAVR does offer some of the following benefits:
- Shorter recovery times
- Minimally invasive
- Significantly less pain than open-heart surgery
- Shorter hospital stay than open-heart surgery
- Life-saving option for intermediate and high-risk patients
“We have patients who have been biking, hiking, golfing after TAVR. People are traveling. Their quality of life has improved,” said Dr. Mungee. “You don’t have to feel short of breath with routine activities and certainly don’t blame it on age alone. They’ll tell you the next morning of procedure, ‘I can breathe.’ That’s how much of a difference TAVR makes, and how quickly that difference is felt.”
Another major advantage to TAVR is the possibility of using a minimalist approach now routinely performed at OSF Saint Francis Medical Center in Peoria.
“The Minimal Approach TAVR allows the patient to come to a hybrid catheter lab with only a peripheral IV. The TAVR is performed with no general anesthesia or intubation and no surgical incision,” said Dr. Mungee. “A Minimal Approach TAVR patient is normally up eating dinner that same evening. Imagine a heart valve replacement without open chest, no skin incision and only minimal anesthesia.”
As with all medical procedures, recovery is based on the individual. While some may leave the hospital needing only minimal support, others might require the support of an active caregiver. You should consult with your health care team and develop a plan to manage your specific situation.
The HeartCare Midwest TAVR team at OSF Saint Francis Medical Center has performed nearly 250 successful TAVR procedures. To learn more about TAVR, or to see if you are a TAVR candidate, call 800-352-4410 or visit heartcaremw.com.