Transcatheter Aortic Valve Replacement

Changing the face of treatment for patients with aortic stenosis

Doctors Medical Center is now home to a brand new Valve Clinic and we are proud to offer the Transcatheter Aortic Valve Replacement (TAVR) program to residents throughout the Central Valley. Our TAVR team is composed of a multidisciplinary, collaborative group of physicians and caregivers, including interventional cardiologists, cardiothoracic surgeons, imaging specialists, anesthesiologists, advanced care nurses and valve clinic coordinator. This cohesive approach embodies optimal patient centric care and collaborative treatment decisions. The team will conduct a comprehensive evaluation of patients with aortic stenosis to determine whether the TAVR procedure is appropriate and what treatment plans they recommend. We accept most insurance and transfers from hospitals across the Central Valley and beyond. For referrals and more information about the TAVR program at Doctors Medical Center, please call (209) 342-3311.

What is Aortic Stenosis?

Aortic stenosis (AS) is one of the most common and most serious valve disease problems. With AS, the opening of the aortic heart valve narrows. As a result, the heart needs to work harder and may not pump enough oxygen-rich blood to the body. Aortic stenosis can be caused by a birth defect, rheumatic fever, radiation therapy or can be related to age. Approximately 2.5 million people in the United States over the age of 75 suffer from this disease. In elderly patients, aortic stenosis is sometimes caused by the buildup up calcium (mineral deposits) on the aortic valve’s leaflets. Over time, the leaflets become stiff, which reduces their ability to fully open and close. When the leaflets don’t fully open, a person’s heart must work harder to push blood through the aortic valve to the rest of the body. As a result, less oxygen-rich blood flows from the lungs to the brain and rest of the body, which may cause symptoms. 

Factors Associated with Aortic Valve Disease

  • Increasing age
  • High blood pressure
  • High cholesterol
  • Smoking

What are the Symptoms of Aortic Stenosis?

The symptoms of AS are commonly misunderstood by patients as “normal” signs of aging. Common symptoms include:

  • Fainting
  • Breathlessness
  • Chest pain, pressure or tightness
  • Decline in activity level or reduced ability to do routine physical activities

Patients may live with aortic stenosis for many years during a latent, asymptomatic period, even before symptoms of the disease develop. However, after patients begin experiencing symptoms, it is urgent they receive treatment.

Without Treatment, Severe Symptomatic AS can be Life-Threatening.

After the onset of symptoms, patients with severe AS have a survival rate as low at 50% at 2 years and 20% at 5 years without aortic valve replacement. Traditional treatment for this disease is open-heart surgery, which may require extensive hospital stays and recovery times.

There are people who have been diagnosed with severe, symptomatic AS and who are at intermediate-risk for open-heart surgery. Historically, such patients often refuse or are denied surgery. TAVR may be a safer option. 

How is the TAVR Procedure Performed?

TAVR is a less invasive, catheter-based technique for replacing the diseased aortic valve. An interventional cardiologist along with a cardiothoracic surgeon will work together in the TAVR procedure. They will guide a new valve into the heart through an incision in the leg while the heart is still beating, using guidance from X-ray and echocardiography.

The TAVR procedure can be performed through multiple access approaches. However, the most common approach is the transfemoral approach, in which the valve is delivered via a catheter through the femoral artery, as explained above.

What are the Benefits of TAVR?

If you have severe aortic stenosis, TAVR will help your heart to work better. It may also shorten your recovery time to getting back to everyday activities. Quality of life studies have shown patient health improvements within 30 days including the ability to take care of themselves and to participate in everyday activities.

How Long Will My Valve Last?

How long your tissue valve will last depends on many patient factors and medical conditions. Regular follow-ups will help your doctors know how your valve is working.

Patient Impact: TAVR Today

  • Short length of hospital stay
  • Minimally-invasive procedure
  • The survival rate of 30 days for patients at intermediate-risk of open-heart surgery who received this valve is 99% 

Understanding Risk Assessment

An evaluation of the possible risks for each individual patient should be performed if intervention is contemplated. Factors such as the risk of operative mortality, patient frailty, major organ system compromise, other major comorbidities and procedure-specific impediments must be taken into consideration. 

Who Should Not Have TAVR?

The valve and delivery systems should not be used in patients who:

  • Cannot tolerate medications that thin the blood or prevent blood clots from forming
  • Have an active infection in the heart or elsewhere

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