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Transcatheter aortic valve replacement procedure

Transcatheter aortic valve replacement (TAVR) surgery is a minimally invasive surgical option for patients considered high risk for traditional open heart surgery. The hybrid operating room at Via Christi supports this surgical approach.

Each year, about 5 million people are diagnosed with heart valve disease. Of those, about 1.5 million have aortic stenosis — an obstruction or narrowing of the aortic valve which is often caused by the buildup of calcium deposits on the leaflets of the valve. Standard treatment of aortic stenosis is open-heart surgery in which the damaged heart valve is removed and replaced with a prosthetic valve. However, about 500,000 patients in the U.S. have severe aortic stenosis. Because severe aortic stenosis is generally a disease of the elderly, occurring over the age of 75, some of these patients are identified as inoperable or high risk for open-heart surgery as a treatment option.

TAVR is a procedure for those patients with severe aortic stenosis who have other conditions that preclude them from traditional open-heart surgery.

There are two approaches to TAVR treatment: Transfemoral and Transapical.

The Food and Drug Administration approved the TAVR procedure which delivers the Edwards SAPIEN Transcatheter Heart Valve through the femoral artery in the patient's leg in the same manner as a common heart catheterization procedure. This allows inoperable patients to be treated in a way that doesn't require open-chest surgery.

In October 2012, the FDA approved another TAVR delivery method for the Edwards SAPIEN Valve called the transapical procedure, which is indicated for patients with aortic stenosis who don’t have suitable access through their leg artery. In this TAVR procedure, the replacement valve is inserted through an incision between the ribs and through the bottom end of the heart.

Without treatment — replacement of the diseased aortic valve — severe aortic stenosis will shorten life, and has a far higher mortality rate than cancer. Studies show that as many as 50 percent of these patients will not survive more than two years from the onset of their symptoms if not treated surgically.