UnityPoint health Cedar Rapids Heart and Vascular Institute takes you inside the heart for a transcatheter aortic valve replacement.
Or TAVR at UnityPoint Health, Cedar Rapids.
TAVR is a minimally invasive cath-based procedure to replace the aortic valve in a patient with severe aortic stenosis.
It's for individuals that are high-risk or too sick for open-heart surgery.
Left untreated aortic valve stenosis can lead to more serious heart problems. Dr. Georges Hajj from UnityPoint Health
Cardiology Clinic
explains the procedure and who is a candidate for TAVR. The aortic valve is one of the heart valves.
There are four valves in the heart the aortic valve is the valve that sits between the
left bottom chamber of the heart call we call it left ventricle,
which is the main chamber of the heart that pumps the blood through the whole body and
between the aorta, which is the blood vessel the largest blood vessel that we have that comes out of this left ventricle and
distributes the blood to the whole body and
this valve opens and closes it opens when the heart is squeezing when this left ventricle is contracting
to let the blood flow to the whole body and
closes when this left ventricle is relaxing and filling with blood in order to prevent the blood that was just ejected by this
ventricle from leaking backwards into it. And aortic stenosis refers to the aortic valve the stenosis
refers to
inability of this valve to open and very well.
The ventricle although may be working normally the valve not being able to open will decrease blood flow physically to the whole body.
That usually translates into symptoms with exertion,
shortness of breath with exertion, chest discomfort with exertion
Dizziness with exertion because the brain is not getting enough blood flow the heart is not not getting enough blood flow and blood is being
backed up and filling the lungs, which should cause the shortness of breath with exertion.
So when we have severe degree of this aortic valve senosis, and we have symptoms
it is highly recommended to fix.
There are no medication
currently that will slow those the progression of this disease or or or cure it. The only treatment is a procedure
there are two ways we can do this. Classically we
replace the aortic valve surgically. The surgeon cuts the chest open stops the heart uses a
an artificial heart for a certain amount of time.
Enough for him or her to remove the defective valve and place a
prosthetic valve in place. Then the heart is restarted
after patient heart is stopped chest is closed. And this is typically what we call AVR - aortic valve replacement.
Now over the last few years there has been a lot of advances in how we do this treatment.
We added a "T" before the AVR and becomes TAVR so transcatheter aortic valve replacement and
that refers to
replacing the hard path
without cutting the chest open by making an incision in the groin and
accessing the artery that's in the groin and from there going back to the heart and
placing a valve
inside the patient's previous valve. We use the defective valve to anchor the new valve in place this old
defective valve gets crushed against the wall of the aorta, which is that blood vessel that comes out of the left ventricle.
And
this new valve starts functioning immediately. Our patient undergoing TAVR is Donald Waterman an
88 year old from Eastern Iowa. He was experiencing a rapid and irregular heart rate and went to St.
Luke's ER. Up to that point in time Waterman had been closely monitored by a UnityPoint Health
Cardiologist. With this change in condition it was determined. He would undergo the TAVR procedure.
I would say about at least a third of the patients
have been able to go home the next morning after having a heart valve replaced
the day before and
The team has
Grown, and we now are implanting?
All the valves that are on the market all the different valves and of course each valve
has
certain features and certain patients may benefit more from one or the other most patients will do very well with either one of the valves.
Family reports Waterman is feeling less tired after his procedure and feel he was in the right place at the right time.
They indicate his quality of life is better and feel fortunate to have this option in Cedar Rapids.
Allowing them to stay close to home and avoid travel.
Patient satisfaction has been great and again
I want to remind patients that this treatment currently for patients with
intermediate or high risk of having
complications or
having or or dying from an opening classical opening heart surgery with
with valve replacement of surgery alone.
For patients who are at low risk we don't know yet if they will do
well or not.
This is being studied in the research trials. Sfor patients who are elderly who are frail and
again, we calculate a score that tells us what is the chance that this patient is going to have a major
complication
from a classical open-heart surgery and it
says that it's intermediate or if it's high
then we tend to do the TAVR.
And mainly because it has been proven that TAVR is either equal or superior in this patient especially in the patients that are
high-risk is acting superior to surgery and the
with the advantage of quicker recovery that's pain and discomfort going home sooner
as opposed to classical open heart.
UnityPoint Health - Cedar Rapids Heart and Vascular Institute offers advanced technologies and
procedures to help patients stay close to home.
We invite you to learn more about UnityPoint Health heart care services and how to prevent heart disease.