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Transcatheter Aortic Valve Replacement (TAVR)


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Medications cannot cure a damaged heart valve (aortic valve stenosis). They can only ease the symptoms. The only way to treat the disease is surgery to repair or replace the diseased valve and open up the passageway. We offer a wide range of services including:

  • Transcatheter Aortic Valve Replacement (TAVR)
  • ASD (Atrial Septal Defect) Closure
  • PFO (Patent Foramen Ovale) Closure
  • Valvuloplasty – have each of these anchored to more info below.
  • Paravalvular Leak Closure
  • Traditional or Minimally Invasive AVR
  • Mitral Valve Repair
  • Left Atrial Appendage Closure via the Watchman Device

ASD (Atrial Septum Defect) Closure 
An ASD is a rare congenital defect in the wall (septum) that divides the upper chambers of the heart into the left and right atrium. This defect can cause the pressure in the lungs to build up which over time causes less oxygen to be in the blood.  Symptoms may include fatigue and shortness of breath.  If left untreated, an ASD can result in heart failure or stroke.   The majority of the time the defect can be closed by placing an ASD closure device into the heart through a tube placed into a blood vessel through a tiny incision in the groin.  To learn more about ASD, click here.

PFO (Patent Foramen Ovale) Closure 
A Patent foramen ovale (PFO) is a hole between the left and right atria (upper chambers) of the heart that fails to close naturally shortly after birth. Treatment most often requires a procedure called a cardiac catheterization.
To learn more about PFO, click here.

Balloon Valvuloplasty 
Many patients with degenerative valve disease are ineligible for surgery because of their high-risk status (e.g., advanced age, multiple comorbidities or end-stage disease). Balloon valvuloplasty may be used in these patients to relieve symptoms.  However, balloon valvuloplasty is not a permanent solution and often is used in people who are waiting for a TAVR.

In balloon valvuloplasty, a catheter (thin, flexible tube) with a small, deflated balloon attached to the tip is threaded through a small hole into a blood vessel in the groin. The balloon is positioned across the narrowed valve and is inflated to stretch the valve opening and allow more blood to flow through it. The balloon is then deflated, and the catheter with the balloon is guided back out of your body. 

Paravalvular Leak Repair 
A paravalvular leak (PVL) is a leak around the seal between the prosthetic valve and the heart tissue following the replacement of a mitral or aortic valve.  This can result in fatigue, shortness of breath, fluid retention, and fever. 

If the PVL is severe either a transcatheter procedure or surgical approach must be used to seal the leak. The least invasive option seals the leak by approaching the valve with a catheter run through an artery in the groin. This is also known as a transcatheter approach. If this is not possible, for reasons determined by the physician, then a surgical approach would be required.

 
Minimally Invasive Surgery
Minimally invasive surgery is a highly specialized procedure in which our surgeons operate through small incisions, or operating ports, just large enough to allow a tiny camera and surgical tools to enter the surgical site.  A 2-inch incision between the ribs on the side of the chest is used versus a traditional open-heart valve procedure of a 12-inch incision through a full zipper scar down the chest as seen in the diagram on the right.
 Description: Heart bypass surgery incision                                             
This technique cuts down on the amount of stiches and scarring to the patient. Also the recovery time including the length of stay in the hospital can be decreased. Patients can return to normal activities faster and with fewer restrictions and less pain than with a conventional approach to heart surgery.
The benefits of minimally invasive valve surgery for the treatment of heart valve conditions may include:

  • Better long-term survival
  • Better preservation of heart function and anatomy
  • Small sternotomy or small thoracotomy
  • Shorter hospital stays usually about four days or less
  • Lower risk of complications post-surgery, including blood loss and infections
  • Minimal scarring and improved cosmetically with very little visible chest incision.
  • Patient experiences much less pain
  • Faster recovery time and return to normal activities in recovery times of 2 weeks versus 2 months.

Valve surgeries, including repairs and replacements, are the most common minimally invasive procedures.  Our surgical team will carefully evaluate the advantages and disadvantages of this type of procedure with you.  We will review the results of your diagnostic tests before determining if you are a candidate for any of these minimally invasive procedures.

Learn more here.


*Content on this page compliments of the ADAM Medical Library.