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First patient at Orlando Health undergoes transcatheter aortic valve replacement

September 22, 2012

Catheter used during transcatheter aortic valve replacement (TAVR) procedure. The transcatheter aortic valve replacement (TAVR) procedure is designed for high-risk patients living with severe chest pain, congestive heart failure or symptoms of aortic stenosis — an age-related heart disease that develops when calcium deposits cause the aortic valve to narrow, forcing the heart to work harder to pump enough blood through a smaller opening.

“TAVR is definitely a game changer,” said Deepak Vivek, MD, interventional cardiologist and director of the Orlando Health Heart Institute Heart Valve Center. “These patients previously would have no hope for improvement. They would eventually succumb to their disease and their symptoms would not get better. There are really no medications available that would perform a long-lasting benefit. By offering our patients the revolutionary TAVR procedure, it significantly improves their symptoms and prolongs their life expectancy.”

Irving DeKoff, the Orlando Health Heart Institute’s first patient to have the TAVR procedure, shares his story in the video below:

Prior to the TAVR procedure, patients would have little chance of relief from medical symptoms, making it nearly impossible to improve quality of life.

“The hope is that we can give patients a valve that will function, which dramatically relieves the heart’s workload so that they can breathe better, stay out of the hospital and spend more time with their family. With comprehensive rehabilitation following the procedure, patients can also regain some mobility and independence.” said Mark Sand, MD, cardiothoracic surgeon and chief of staff at Orlando Health.

The artificial valve, called the Sapien THV and manufactured by Edwards Lifesciences, is made of cow heart tissue and a polyethylene skirt and is supported with a stainless steel mesh frame. The medical team takes a new route to the narrowed heart valve by going through a leg artery instead of a chest incision, which is typically done during traditional open heart surgery.

“To put it in its simplest terms, it is a valve on a stick,” said Jeffrey Bott, MD, cardiothoracic surgeon and chair of Thoracic Surgery at Orlando Regional Medical Center. “We are able to get access to a patient’s bloodstream through their groin and slide a new valve that is on the end of a catheter up into the aortic valve area. Before we deploy the new valve, we use a balloon to expand the area. Once we deploy the new valve, it is functional instantaneously.”

The new approach combines the expertise of various specialists, comprised of nearly 40 clinicians for each procedure.

“Collaboration on this program is essential and requires a multidisciplinary team,” said Barry Weinstock, MD, interventional cardiologist at the Orlando Health Heart Institute. “While the procedure sounds very simple, it is actually relatively complex and requires a lot of collaboration, both in accessing the patients before starting the procedure and during the actual procedure itself.”

For more information on the TAVR procedure, please call the Orlando Health Heart Institute at 321.841.6444 or click here.