Specialists at the Washington University and Barnes-Jewish Heart & Vascular Center are the first in the region to add a second valve option for use in the transcatheter aortic valve replacement (TAVR) procedure, making it possible to treat a wider range of patients.
Minimally invasive, TAVR is used to treat patients with severe aortic stenosis, a life-threatening disease which narrows the heart’s aortic valve, who are typically considered inoperable or at very high risk for open-heart surgery. Aortic stenosis affects about 100,000 people in the U.S., typically around the ages of 50 to 70.
A team of Washington University cardiologists and cardiothoracic surgeons recently were first in the region to use the new CoreValve System when performing TAVR procedures. The two patients who received the self-expandable valve, both considered to be at extreme-risk for traditional aortic valve replacement, are recovering at home.
“Having two valve options now gives us the opportunity to expand the number of patients we can help who are not good candidates for traditional open-heart valve replacement surgery, as we have a larger variety of valve sizes and implantation routes,” said Alan Zajarias, MD, Washington University interventional cardiologist at Barnes-Jewish Hospital.
During the TAVR procedure, a catheter is inserted through an incision in a patient’s leg or chest and threaded through an artery to the aorta. With the new self-expandable device, a stent and the prosthetic valve automatically open when the catheter is in place and unsheathed. The Heart & Vascular Center is the only center in the region currently able to offer patients the option of this new valve in addition to the device first approved by the U.S. Food and Drug Administration (FDA) in 2011, called the SAPIEN valve, which is delivered via a collapsible mesh stent and opened by a collapsible balloon.
“There are certain anatomic features of given patients that may make a patient more suitable for one valve or the other,” said Hersh Maniar, MD, Washington University cardiothoracic surgeon at Barnes-Jewish Hospital. “There may not be one best valve for all patients, so having multiple valves and delivery options now allows us to take a specialized approach to treat patients who meet the appropriate criteria.”
The Heart & Vascular Center was the first and is the most experienced in the region to offer the TAVR procedure. Physicians at the center have been successfully performing TAVR since 2008 and have participated in the clinical trials leading to the FDA approval of this technology.
The CoreValve System, manufactured by Medtronic, Inc., was approved by the FDA in Jan. 2014. The SAPIEN valve, developed by Edwards Lifesciences, was approved by the FDA in Nov. 2011.
For more information about valve replacement options, call 855-45-HEART.
Barnes-Jewish Hospital is a 1,315 bed teaching hospital affiliated with Washington University School of Medicine in St. Louis, Mo. The hospital has a 1,763 member medical staff, with many recognized as “Best Doctors in America.” Barnes-Jewish is a member of BJC HealthCare, which provides a full range of health care services through its 13 hospitals and more than 100 health care sites in Missouri and Illinois. Barnes-Jewish Hospital is also consistently ranked as one of America’s “Best Hospitals” by U.S. News & World Report.