06:29am Friday 23 August 2019

Allegheny General Hospital is First in the Region to Offer New, Minimally-Invasive Heart Valve Replacement Technique

Called Transapical Transcatheter Aortic Valve Replacement (TAVR), the procedure is performed through a small chest incision that provides direct access into the heart.

Transapical TAVR is the latest FDA-approved treatment for people suffering from severe aortic valve stenosis, a narrowing of the aortic valve of the heart which causes it to open and close improperly. Aortic stenosis forces the heart to work harder to push blood through the damaged aortic valve and eventually the heart’s muscles weaken, resulting in heart failure and death.

Physicians at AGH’s Cardiovascular Institute have been performing transfemoral TAVR procedures for the past year, an approach in which the femoral artery serves as a conduit to access the heart. Surgeons make a small incision in the groin and guide the replacement valve through the femoral artery to the heart.

Patients with smaller or diseased peripheral blood vessels, however, may not be candidates for transfemoral TAVR said AGH cardiothoracic surgeon Stephen Bailey, MD. In the transapical approach, a small incision is made between the ribs of the left lower chest through which the replacement valve is inserted via a catheter directly into the heart.

“With direct access to the heart, the transapical approach allows us to dramatically reduce the invasiveness of this procedure compared to conventional surgical aortic valve replacement,” said Dr. Bailey, who serves as Director of Cardiac Surgery at AGH. “As a result, many patients who would be at high risk for traditional aortic valve replacement surgery and who are not candidates for transfemoral TAVR now have a life-saving option that avoids the heart-lung machine.”

The Food and Drug Administration approved TAVR for use in high risk patients in 2012. Since then, AGH has performed 24 cases, including six using the transapical approach.

“It’s exciting to be able to help patients with symptomatic aortic stenosis who previously were not candidates for either conventional aortic valve surgery or the transfemoral TAVR procedure regain their health,” said David Lasorda, DO, FACC, Director of AGH’s Division of Interventional Cardiology. “The transapical approach gives us another option for these very high risk patients who really need aortic valve replacement to survive.”

“The minimally invasive procedure improves symptoms and quality of life for a number of our high risk aortic stenosis patients, most of whom are elderly,” said Diane Berger, RN, BSN, Valve Clinic coordinator at AGH.

Allegheny General’s team of interventional cardiologists, cardiothoracic surgeons, cardiac imaging specialists and cardiac anesthesiologists carefully evaluate all patients with aortic stenosis to determine which medical and surgical options, including the transfemoral and transapical TAVR procedures, are likely to yield optimal outcomes.

“For more than 50 years, Allegheny General Hospital has been a leader in providing solutions for patients who have complex diseases of the heart and blood vessels, including aortic valve disease,” said Srinivas Murali, MD, Director of AGH’s Division of Cardiovascular Medicine and Medical Director of the hospital’s Cardiovascular Institute.

“We have a constant drive for cutting edge, innovative therapies and transapical TAVR is the latest tool in our arsenal of diagnostic and treatment options that enables us to provide our cardiovascular patients with excellent care.”


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