TAVR: Groundbreaking Treatment for Aortic Stenosis
Due to our team’s experience and expertise in transcatheter aortic valve replacement (TAVR) University Hospitals Harrington Heart & Vascular Institute is recognized as a high-volume Center of Excellence. As one of the first in the country to use this approach, we continue to refine our technique in this groundbreaking aortic stenosis treatment.
Through research and innovation, our team now uses a minimally invasive, light sedation approach for valve surgery. We are the first training site for this more advanced TAVR approach and work with other centers across the U.S. to teach this improved approach. Our leadership on optimal TAVR practices is recognized internationally and our physicians teach this procedure all over the world.
Improved Techniques Benefit Patients with Aortic Stenosis
What was previously major open-heart surgery for valve repair or replacement is now often performed through smaller incisions. Minimally invasive techniques benefit patients with less scarring and pain, shorter hospital stays and faster recovery. Our specialized team at University Hospitals offers a range of treatment options for aortic stenosis, including:
- Mini-thoracotomy for valve repair and replacement, which enables surgery through an incision between the ribs, without opening the sternum, or breastbone.
- During a TAVR procedure, the new valve is delivered through a catheter, or hollow wire, threaded through an artery in the leg to the heart. The new valve is then inflated, replacing the existing valve on the sides of the aorta. The recovery process from our more minimally invasive, light sedation TAVR procedure is also faster as most patients return home within 48 hours after the procedure.
- Stentless aortic valve prostheses: These biologic (tissue) valves are equivalent to human valve transplants and exhibit excellent hemodynamics, or blood flow. UH has some of the greatest expertise with these valves in the world.
What is Aortic Stenosis?
The narrowing of the aortic valve opening, called aortic stenosis, is a common but serious heart valve disease problem. The aorta is one of four heart valves that ensure blood flows in the right direction through the heart chambers to the rest of the body. Stenosis occurs if the valve doesn’t work as it should, making it harder for the heart to pump blood for proper circulation.
As a result, pressure builds and thickens the heart muscle. At some point, the valve will become too narrow for the heart to function. When this happens, you may experience chest pain, shortness of breath, heart palpitations or swollen ankles and feet. In severe aortic stenosis instances, the heart-weakening effects of aortic stenosis can lead to heart failure.
Our multidisciplinary approach at University Hospitals enhances our ability to treat patients with complex heart and vascular conditions, including aortic stenosis. We bring together an entire team of heart and vascular specialists at our advanced Valve and Structural Heart Disease Center who are dedicated to collaborative care for a seamless patient experience and the very best treatment options for aortic stenosis.
Understanding Aortic Stenosis Risk Factors
Aortic stenosis may be caused by a congenital heart defect, or one present at birth. Other risk factors can include:
- Advanced age, usually after age 60
- Family history of early heart disease
- High blood cholesterol
- High blood pressure
- History of infection such as infective endocarditis, rheumatic fever, heart attack, heart failure or heart valve disease
- Insulin resistance
Heart-healthy eating, physical activity and other lifestyle changes as well as medications aimed at preventing coronary heart disease may help prevent aortic stenosis.
Advanced Diagnostic Testing
Your primary care doctor may detect a heart murmur or other signs of heart valve disease during a routine exam and refer you to a cardiologist, a doctor who specializes in diagnosing and treating heart problems. In addition to asking about your signs and symptoms, your doctor may recommend other tests to diagnose aortic stenosis, including:
- Cardiac catheterization: With this procedure, a long, thin tube (catheter) is inserted into a large artery in the leg or arm leading to the heart to provide images of the heart and blood vessels.
- Cardiac magnetic resonance imaging (MRI): This noninvasive test uses a combination of large magnets, radio waves and a computer to produce detailed images of the heart and other vital organs.
- Chest X-ray: This gives an overall picture of the heart and lungs.
- Echocardiogram (Echo): This test uses sound waves to give a moving picture of the heart and valves. This is one of the best tests for aortic stenosis.
- Electrocardiogram (ECG): This test measures the electrical activity of the heart.
- Exercise testing: A stress test that can show whether you have signs and symptoms of heart valve disease when your heart is working harder than normal.
- Pulse oximetry: This noninvasive test measures oxygen levels in the blood through a clip placed on a finger.
Heart and Vascular Rehabilitation Program Provides Safe and Supervised Recovery Plan
Patients receive comprehensive rehabilitative care through University Hospitals’ Cardiovascular Rehabilitation Program. Rehabilitation begins during hospitalization and continues in a safe, supervised outpatient setting. Our expert cardiovascular rehabilitation team is comprised of highly skilled nurses, exercise physiologists, registered dietitians, pharmacists, psychologists and cardiologists who work together to help patients return to an active lifestyle. Cardiac rehabilitation at UH typically spans 12 weeks, where patients receive personalized instruction in the following areas:
- Stress reduction
- Smoking cessation
- Education on how the heart works
Learn More about UH Care for Aortic Stenosis
To learn more about heart valve disease, including aortic stenosis, and how University Hospitals can help, contact one of our team members at a convenient location near you.