People with severe aortic valve stenosis (narrowing) have a new option for valve replacement, now that the FDA has made the less-invasive, catheter-based treatment known as transcatheter aortic valve replacement, or TAVR, available to more patients. At St. Clair Hospital, TAVR is being performed by a team of expert cardiovascular surgeons, led by Andy C. Kiser, M.D., M.B.A., chief of cardiac surgery at St. Clair, and Ryan Zuzek, M.D., interventional cardiologist and director of the Cardiac Catheterization Lab at St. Clair.
TAVR was previously reserved for patients who were too high risk, due to frailty, age or other conditions, to endure traditional valve replacement through open chest surgery. “People with severe aortic stenosis who were low risk for surgery didn’t qualify for TAVR and had to have open chest surgery, but now the options are wide open,” Dr. Zuzek says. “We have a heart team conference about each individual patient, and a risks/benefits discussion with the patient about the most appropriate treatment.”
TAVR and open chest surgery are significantly different. The TAVR procedure is a minimally invasive approach in which a catheter with a prosthetic valve at the end is introduced via a femoral puncture and advanced to the heart with high-tech imaging. The procedure is usually completed within two hours. Patients spend one to two days in the Cardiovascular Surgical Unit for recovery and monitoring of their cardiac functioning. Open chest valve replacement is far more complex, involving a large sternal incision, intubation, hours of anesthesia and the use of a heart-lung bypass machine. Patients may experience discomfort and their recovery may take up to two months.
“TAVR is a good option for anyone with severe aortic valve stenosis,” says Dr. Zuzek. “It’s wonderful when we see the patients at follow-up. They have their lives back.”
For more information on TAVR at St. Clair Hospital, please call 412.942.5728.