When valve replacement is the preferred treatment option, an investigational procedure is providing options for aortic stenosis patients who previously were considered inoperable.

Heart & Vascular Center is a national leader in performing transcatheter aortic valve replacement (also known as percutaneous aortic valve replacement).This minimally-invasive approach is providing groundbreaking results for patients who have severe aortic stenosis, a condition where the aortic heart valve does not open wide enough to let adequate blood flow through.

When percutaneous aortic valve replacement is performed through the femoral artery, there are no major incisions involved and the heart is never stopped or put on bypass. A small incision is made in the leg, near the groin, and a catheter is thread through a vein in the leg to the heart. Once it reaches the diseased valve, the catheter deploys a stent-type replacement valve which is ballooned open, pushing aside the old valve and immediately assuming function as the new valve.

Edwards SAPIEN transcatheter heart valve. Courtesy Edwards Lifesciences		Balloon catheter inflated to secure the replacement valve inside the diseased valve to improve blood flow from the left ventricle into the aorta.

An alternative valve replacement procedure is being studied that would insert the replacement valve through an incision in the ribs rather than the femoral artery in the leg. This option may require larger incisions, but is still less invasive than bypass and could benefit patients with very small blood vessels.

The average recovery time for either approach is much shorter than for traditional surgical valve replacement, and patients report significantly less pain with the minimally-invasive approach. Candidates for percutaneous aortic valve replacement must have severe valve stenosis and be considered inoperable or at very high risk for surgical valve replacement. 

Percutaneous aortic valve replacement requires a team approach, combining the efforts of interventional cardiologists and cardiothoracic surgeons. 



Our Heart & Vascular Center is one of 23 heart centers (17 in the United States) that were selected to participate in the PARTNER trial (Placement of AoRTic traNscathetER valves), which led to the FDA’s approval of the transcatheter aortic valve replacement procedure on November 2, 2011. Barnes-Jewish is the only hospital in the St. Louis area to offer this unique minimally invasive aortic valve replacement option. Our surgeons and cardiologists have been performing this technique since 2008.