On Wednesday, two patients with inoperable heart valve disease received new aortic valves at King’s Daughters Medical Center in the area’s first transcatheter valve replacements.
Both patients are doing well, according to cardiothoracic surgeon Robert Fried, M.D., who spearheaded the medical center’s transcatheter aortic valve replacement (TAVR) program.
In late 2011, the TAVR for patients too sick or frail to withstand open-heart surgery. King’s Daughters heart experts have been working to bring the procedure to the region since that time.
King’s Daughters TAVR team includes cardiothoracic surgeons Robert Fried, M.D., and Eric Bronstein, M.D., cardiologists Sriharsha Velury, M.D., and Terence Ross, M.D., cardiac anesthesiologist Oscar Penate, M.D., interventional radiologist Wes Lewis, M.D., and vascular surgeon Omran Abul-Khoudoud, M.D.
Nurse practitioner Larissa Pitts, TAVR program coordinator, worked with physicians, administrators and Edwards Lifesciences, maker of the devices, to implement the program.
“We are very excited to be able to offer this advanced technology to the region,” Dr. Fried said. “It offers the hope of a better, longer life to very ill patients with aortic valve disease who previously had no options,” he said.
Blood from the heart flows through the aortic valve to the rest of the body. A diseased aortic valve may not open all the way, limiting the amount of blood available to body tissues, or may not close completely, causing blood to leak back into the heart. In either case, patients can experience extreme shortness of breath, fatigue, chest pain, dizziness, heart palpitations and murmurs.
These symptoms can be quite severe and life-limiting, Dr. Fried noted.
The TAVR procedure is performed similar to a cardiac catheterization. After the patient receives anesthesia, a balloon catheter is guided through the femoral (leg) artery to aorta and on to the aortic valve. Once in place, the cardiologist deploys the balloon, destroying any calcification and restoring the size of the aortic valve opening.
The balloon is removed and a catheter carrying the new valve is guided through the arteries to the aortic valve. Once in place, the valve is deployed and begins working immediately.
“That we are performing TAVR here, now, demonstrates the commitment King’s Daughters has to bringing world-class healthcare to our communities,” Dr. Fried said. “King’s Daughters commitment to innovation, coupled with the collaboration and dedication of all of our heart specialists, makes our heart program truly remarkable,” he added.
In clinical trials, TAVR demonstrated a reduction in symptoms and improvement in patients’ quality of life as well as increased life expectancy. TAVR has been in trials for a number of years in the U.S. prior to the 2011 FDA approval and has been an approved procedure in Europe since 2007.
The replacement valve is made of cow tissue and polyester fabric on a stainless steel mesh frame, similar to the stents currently used in cardiac catheterization.
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