February 26, 2018
The heart contains four valves: aortic, tricuspid, pulmonary, and mitral. Each is connected to a different heart chamber and plays its own important role in healthy circulation. However, when one of these valves becomes diseased, it can result in problems such as excess strain on the heart or reduced oxygen supply throughout the body. Forms of valve disease include regurgitation, prolapse, and atresia. However, stenosis, particularly of the aortic valve, represents one of the most common and most serious.
Stenosis is a condition that can cause narrowing of any of the four valves through thickening, fusing, or stiffening of the flaps. This prevents the valve from opening fully and inhibits its ability to move blood efficiently. In the aortic valve, stenosis restricts the flow of blood from the left ventricle to the aorta. It may also result in increased pressure within the left atrium. Symptoms of the condition may include feeling faint, fatigued, short of breath, or experiencing chest pain or tightness. Over time, these symptoms may worsen and the muscle wall of the left ventricle can thicken, putting patients at risk for eventual heart failure.
Heart valve replacement is most often performed via open heart surgery where a procedure known as a sternotomy is used to separate the chest wall. Unfortunately, this major surgical procedure poses too great a risk for many patients. In these cases, a transcatheter heart valve (THV) could be the solution. Approved by the FDA for inoperable aortic stenosis in 2011, these valves and the TAVR procedure have revolutionized available treatment options for valve disease.
During the minimally invasive TAVR procedure, a damaged and diseased valve is repaired without being removed. Similar to placing a stent, TAVR uses a catheter to place a fully collapsible THV into the existing aortic valve. Once placement is complete, the new valve is expanded and takes over the task of properly regulating blood flow.
TAVR is not a replacement for traditional valve repair or replacement surgeries. Rather, it is a new, less invasive option for those with severe, symptomatic aortic stenosis who are considered too high-risk for other surgical alternatives. Additionally, more recent FDA approvals allow for TAVR to also be used in certain cases where a previous aortic valve replacement is no longer functioning as it should.
Determining if someone may benefit from TAVR is a decision that will be reached by a cardiovascular surgeon following careful analysis of the patient’s age, medical history, current state of health, and condition of their heart. Health factors such as lung and kidney disease, stroke, COPD, arrhythmias, or previous surgeries can all play a role in a patient’s candidacy for TAVR. For those who do qualify, TAVR can help safeguard the heart as well as improve quality of life through symptom reduction.
If you are suffering from symptomatic aortic stenosis and would like to know more about your treatment options including TAVR, contact Cardiovascular Institute of the South. Among our world-class cardiologists are three who have become leaders in the transcatheter aortic valve replacement procedure. Click below to learn more about each of them, and schedule your own consultation today.