New technology to replace heart valves has helped 300 hearts beat stronger and longer. The Transcatheter Aortic Valve Replacement (TAVR) Program at the Orlando Health Heart Institute recently reached the 300-patient milestone in just under six years. Initially, TAVR was used to treat severe aortic stenosis in patients who were at high or extreme risk for surgery. As the national experience with TAVR has increased, guidelines now also allow TAVR to be offered to select patients deemed to be intermediate risk for surgery. Untreated, aortic valve stenosis can lead to serious heart problems including heart failure and even death.
TAVR technology began as a generational leap forward for patients who were not able to undergo surgery. Over the years new valve systems continue to advance allowing for smaller incisions, shorter procedure time, fewer days in the hospital and a faster recovery.
“We treated our first patient in July 2012, and since that time we’ve treated more than 300 patients with excellent outcomes,” said Deepak Vivek, MD, interventional cardiologist and director, Orlando Health Heart Institute Valve Center. “It is exciting for us to see how well our patients are doing when they return for follow-up appointments. We are adding quality and quantity of life of our patients in their 60s, 70s, 80s, and up to mid-90s.”
The new technology replaces a diseased aortic heart valve through a minimally invasive procedure, without open-heart surgery and without surgical removal of the diseased valve. The device is typically inserted via an artery in the leg and then guided through the arteries into the heart. Once in place, the device expands and takes over the original valve’s function to enable oxygen-rich blood to flow efficiently out of the heart.
Aortic stenosis is a common heart problem caused by a narrowing of the heart’s aortic valve due to excessive calcium deposited on the valve leaflets. When the valve narrows, it does not open or close properly, making the heart work harder to pump blood throughout the body. Eventually, this causes the heart to weaken and function poorly, which may lead to heart failure and increased risk for sudden cardiac death. Aortic stenosis typically occurs in people over 65 years of age.
Aortic stenosis is very debilitating and degrades quality of life greatly.
“Because of the chest pain, rhythm problems, heart failure, shortness of breath and other symptoms, patients aren’t able spend time with their grandchildren in a functional manner, they aren’t able to take walks in the park, and with such difficulty breathing they may have to sit in a chair or sleep on three or four pillows at night,” said Dr. Vivek.
TAVR offers a new lease on life.
“In certain situations, when a patient begins to manifest symptoms and the valve area decreases to serious or critical aortic stenosis, the expected survival can be as short as a couple of years,” said Vijay Kasi, MD, PhD, interventional cardiologist, director of cardiovascular research, Orlando Health Heart Institute. “Something has to be done. This is where aortic valve replacement comes in to play. This new valve technology is especially helpful in patients who at higher risk or are not candidates for open surgical replacement.”
“Giving a patient a valve that will function relieves the heart’s workload dramatically,” said Mark Sand, MD, cardiothoracic surgeon, Orlando Health Heart Institute Cardiovascular and Thoracic Surgery Group. “Afterwards patients are able to breathe better, spend less time in the hospital, enjoy more time with their family, recover sooner, feel better quickly and regain mobility and independence.”
The TAVR Program combines the expertise of various specialists including cardiologists, cardiothoracic surgeons, nurses and other clinicians.