Saint Thomas offers new aortic heart valve treatment
Treatment gives previously inoperable heart patients new option
May 31, 2012, 11:42 a.m.
Nashville, TN A team of cardiologists and cardiovascular surgeons with Saint Thomas Heart at Saint Thomas Hospital recently completed the hospital's first transcatheter aortic valve replacement (TAVR).
Four patients have already received the artificial aortic heart valve approved by the FDA in November 2011 and now covered by Medicare, as announced earlier this month.
Through the combined efforts of Saint Thomas Heart cardiothoracic surgeons, Drs. Mark Tedder and Evelio Rodriguez, as well as cardiologists, Drs. G.S. Scoville, Evans Kemp, Andrew Zurick, and Mark Stankewicz, high-risk and previously inoperable patients with severe symptomatic aortic stenosis are benefiting from this latest advancement in minimally invasive cardiac surgery. Offered by Edwards Lifesciences, the SAPIEN Transcatheter Heart Valve eliminates the need for open-heart surgery for aortic valve replacement, which has been the standard treatment option. The artificial valve is attached to a wire frame and guided by a catheter through the femoral artery in the leg to the heart. It requires only a small groin incision. Once in place, the wire frame enlarges and allows the new valve to pump blood appropriately.
"Saint Thomas Heart has a long tradition of providing the latest therapies that transform the treatment of heart disease. The offering of TAVR is a true collaboration among our cardiologists and cardiovascular surgeons to save the lives of patients who really don't have any other option," said Dr. Rodriguez, director of minimally invasive and robotic cardiac surgery and director of arrhythmia surgery at Saint Thomas Heart at Saint Thomas Hospital.
Severe aortic stenosis impairs the aortic valve's ability to open and close properly and limits oxygen-rich blood flow from the left ventricle to the heart of the aorta.
"This is life-threatening," added Dr. Rodriguez. Without treatment, 50 percent of patients with critical aortic stenosis will not survive more than an average of one to two years after the onset of symptoms."
TAVR is preformed with general anesthesia in a hybrid operating suite at Saint Thomas Hospital, which has both catheterization and surgical capabilities. Furthermore, TAVR is performed on a beating heart and does not require cardio-pulmonary bypass. The surgical team includes interventional cardiologists and imaging specialists, heart surgeons, and cardiac anesthesiologists who all work together, utilizing fluoroscopy and echocardiography to guide the valve to the site of the patient's diseased heart valve.
"Approximately 250,000 people suffer from severe aortic stenosis. It restrains a person's quality of life by limiting simple day-to-day activities," said Dr. Kemp, chairman of the practice oversight committee for Saint Thomas Heart. "About one-third of patients who would require surgery previously had no option because they were deemed inoperable for surgery."
Candidates for the TAVR procedure include patients who suffer from severe aortic stenosis and have been deemed inoperable by a surgeon, In healthy patients, aortic stenosis can be treated, but not cured, by medications. However, for patients who are not candidates for medication or the medication has ceased to work, surgery is the most effective treatment option. Historically, aortic stenosis is more common in elderly patients, typically those who are older than 75 years of age. Many have other serious health issues and have been considered inoperable. However, that is no longer the case as these patients may benefit most from TAVR.
For more information about the TAVR procedure performed by Saint Thomas Heart at Saint Thomas Hospital physicians, visit www.stthomas.org/TAVR. For an animated look at the Edwards SAPIEN transcatheter heart valve in use, visit http://www.edwards.com/products/transcathetervalve/Pages/THVcategory.aspx.
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