Transcatheter Aortic Valve Replacement (TAVR)

The JFK experience has been extraordinary with over 550 cases since its inception, as of November, 2016.  This experience is the busiest in Southeast Florida.

A new procedure at JFK, called transcatheter aortic valve replacement (TAVR), is changing lives of many patients with severe aortic valve stenosis. Traditionally patient must undergo open-heart aortic valve replacement for this condition. With TAVR, one does not have to go through the open heart surgery. This is a promising new procedure for those considered too high risk for traditional open-heart valve replacement or those who were previously considered inoperable. JFK Medical Center is part of a select group of hospitals in the U.S. approved to offer Transcatheter Aortic Valve Replacement (TAVR).

Cardiac Surgeons and Interventional Cardiologist at JFK Medical Center were among the first in the United States, in Palm Beach County and the Treasure Coast to perform the transcatheter aortic valve replacement procedure (TAVR). JFK Medical Center is one of the largest and the most experienced TAVR programs in the state of Florida.

TAVR is performed on high-risk and inoperable patients with severe aortic stenosis. All patients are carefully evaluated to see if they are candidates for traditional surgical aortic valve replacement and then TAVR can be considered for treatment. The goal is to provide the best treatment for each individual patient.

 

What is Aortic Stenosis?

This condition occurs when the aortic valve gradually becomes calcified and thickened which causes a severe narrowing of aortic valve opening that does not allow normal blood flow.

It is usually a degenerative process which develops over years.  In elderly patients, severe aortic stenosis is caused by the build-up of calcium (mineral-deposits) on the aortic valve’s leaflets. The symptoms of severe aortic stenosis include; chest pain, fatigue, shortness of breath, light-headedness, fainting or difficulty when exercising. It is important to remember heart valve disease often occurs with no outward symptoms and may go undetected for some time.

 

How TAVR Works

Through a small puncture in the groin or upper thigh, a catheter is inserted into the femoral artery. Imaging helps the physician guide the catheter through the femoral artery to the diseased aortic valve. The new valve is crimped down to the diameter smaller than a pencil and guided through the catheter with the help of imaging, until it reaches the diseased aortic valve.

Once it reaches the diseased aortic valve, the new valve is expanded into place and allows blood to flow through the aortic valve naturally.

 

Evaluation in Multi-disciplinary Valve Clinic

All potential TAVR patients are evaluated in our multi-disciplinary valve clinic. They are seen by a team of physicians including a Cardiothoracic Surgeon and Interventional Cardiologist. Our valve clinic nurses play an important role in the coordination of patient care and education of the patient and family before and after the procedure. Our patients can call the valve clinic with any questions or concerns. Our team is always available to assist.

What to Expect Following the Procedure

Although patients will need to remain in the hospital for a few days following the replacement, the actual procedure typically takes between 1-2 hours to complete. Compared to a lengthy heart surgery and a recovery that spans several months, the transcatheter aortic valve replacement demands a much smaller interruption of life activities.

 

Benefits and Risks

The crucial time window following a transcatheter aortic valve replacement is 30 days. During this time, patients have a higher risk of strokes and vascular disorders. Bleeding problems could also be a concern, but these instances occur more frequently with those who have undergone traditional heart surgery. Despite the risks, the development of this noninvasive valve replacement has dramatically improved the survival chances of those with aortic stenosis. So far, recovery rates have matched those of traditional surgery, while dramatically surpassing other noninvasive procedures.

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