Heart Valve Innovation is Treating the Inoperable (Video)

TAVR offers alternative to open heart surgery

The award-winning Edwards SAPIEN Transcatheter Heart Valve is giving new hope to high risk patients with valve disease.

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Cleveland Clinic cardiologists were among the first clinicians in the country to use the device in an innovative procedure called transcatheter aortic valve replacement (TAVR)—a minimally invasive technique for replacing a diseased aortic heart valve.

New hope for patients

TAVR is indicated for patients, especially older patients, who are too high risk to undergo traditional open-heart surgery. The average age of patients undergoing TAVR is 84 years, and 20 percent are 90 years or older. The procedure requires only a small incision, and patients do not need to be on a heart-lung machine.

“One of the beauties of these transcatheter procedures is that we now have a new option for patients,” says Lars Svensson, MD, PhD, director of the Aorta Center at Cleveland Clinic. Dr. Svensson helped develop the new transapical technique beginning in 2004, and he was co-principal investigator of the clinical trial that tested the efficacy of TAVR.

Watch TAVR in action

TAVR received FDA approval in 2011 and then wider approval in 2012. Learn more in this video:

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Dr. Svensson adds: “There are times when we have a family in front of us with high expectations, and this is the last hope for helping them. We go through all of the tests—and when we are able to say, ‘Yes, you are a candidate for TAVR,’ it’s wonderful.”

How it works

A) Balloon catheter in the diseased valve; B) Balloon with valve in place; C) Balloon inflation to secure the valve

A) Balloon catheter in the diseased valve; B) Balloon with valve in place; C) Balloon inflation to secure the valve

TAVR delivers the collapsible artificial valve into the heart using a catheter. One approach involves a small incision in the groin to gain access to an artery. Other approaches are performed between the ribs (trans-apical) or in the top of the breastbone (trans-aortic). The artificial valve, made of porous wire mesh netting, is expanded inside the native heart valve by inflating a balloon—and almost immediately starts working.

The recovery time is relatively short, with many patients getting back to their normal lives within a couple of weeks. Cardiac rehabilitation is recommended.

It’s no wonder that Popular Science has selected the Edwards SAPIEN Transcatheter Heart Valve as the Grand Award Winner in the health category in the publication’s annual “Best of What’s New Awards.”

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Cleveland Clinic’s TAVR experience

Cleveland Clinic was one of three early pioneering centers in the United States and one of more than 20 centers involved in TAVR clinical trials. In trials, patients who received the valve were 40 percent more likely to be alive a year later.

FAQs about percutaneous transcatheter aortic valve replacement can be found in previous web chat transcripts.