New Approach for Transcatheter Aortic Valve Replacement (TAVR)
Stony Brook, NY - Stony Brook University Hospital is performing a new FDA-approved minimally invasive procedure to replace the aortic heart valve through a small chest wall incision without open-heart surgery, as an alternative for patients with limited access to the aorta through their femoral arteries.
First performed at Stony Brook University Heart Institute on May 29, the transapical procedure is a new approach to Transcatheter Aortic Valve Replacement (TAVR). TAVR can be performed by inserting a catheter into the vessels in the groin (transfemoral) or directly into the heart (transapical) to reach the aorta. The procedure allows the diseased valve to be replaced without open-heart surgery.
The transapical approach is indicated for patients who have inadequate peripheral arterial access for the transfemoral approach, said James Taylor, MD, FACS, Professor of Surgery at Stony Brook University School of Medicine, Chief of the Division of Cardiothoracic Surgery and Co-Director of the Stony Brook University Heart Institute. Elderly patients in particular may have small-caliber femoral and iliac arteries with limited access.
Transapical TAVR “is generally a quicker technique with greater ease in crossing the native aortic valve and in manipulating the prosthetic valve to be deployed,” Dr. Taylor said. It requires an insertion in the patient’s chest between ribs to access the apex, or lowest part, of the patient’s heart. A sheath consisting of a short hollow tube slightly larger than the width of a pencil is inserted through the apex and into the left ventricle of the heart. A balloon is placed through the sheath to reach the aortic valve, then inflated to break open the narrowed valve to replace it. A new valve is inserted within the diseased valve while the patient’s heart is still beating. Continue>
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