UR Medicine Heart and Vascular recently performed its 200th transcatheter aortic valve replacement, a life-saving procedure for seriously ill, aging adults with faulty heart valves. The high-tech treatment restores quality of life for people, many of whom have no other treatments available to them.
“This procedure has dramatically changed the care for the elderly with advanced aortic stenosis who can’t tolerate traditional surgeries,” said Frederick Ling, M.D., director of the Cardiac Catheterization Lab at Strong Memorial Hospital. He leads the region’s most experienced TAVR team.
UR Medicine Heart Valve Center introduced the procedure to the Rochester area in 2012 as a new therapy for people with aortic stenosis who are too fragile to endure traditional open-heart surgery. Specialists are now studying the effectiveness of performing the minimally invasive procedure, currently reserved only for people at high risk for open surgery, for people with low and intermediate surgical risk.
Aortic stenosis is caused by a thickening of the valve, which causes the heart to work harder to push blood through the body. Patients often endure fatigue, dizziness and a poor quality of life.
Pittsford resident Beverly Kluge experienced those symptoms last fall. Her cardiologist identified the narrowed valve and aortic stenosis, as well as an irregular heart rhythm, which a pacemaker implant corrected.
Ling and cardiac surgeon Peter Knight, M.D., led a multidisciplinary team that performed the procedure Dec. 22. Kluge recovered quickly and was grateful to travel to Florida with her husband, retired physician David Kluge.
“I was in and out of the hospital pretty quickly. I had the procedure one day and went home the next,” she said. “The dizziness was gone and I felt really good. I couldn’t be more grateful for how easily this whole process was and how much better I feel.”
How TAVR works
This less-invasive technique for replacing the failing aortic valve usually begins with an incision in the patient’s groin to gain access to the femoral artery. Interventional cardiologists and cardiovascular surgeons work together to thread a catheter that is slightly larger than the width of a pencil through to the heart.
The collapsible valve is crimped down and fed through the catheter. Once inside, it is released, pushing aside the leaflets of the diseased valve. The new valve’s metal stent walls embed into the original valve, locking it into place, and then the catheter is removed. Patients are hospitalized one to four nights before returning home.
UR Medicine Heart & Vascular team was first in the Finger Lakes region to provide the delicate procedure. It was selected because of the comprehensive, experienced team of interventional cardiologists, cardiac and vascular surgeons, anesthesiologists, radiologists and support staff and its comprehensive, team-approach to heart care and expertise in advanced heart failure.
What is aortic stenosis?
The aortic valve allows blood to flow from the heart's lower left chamber, or ventricle, into the aorta and to the body. Stenosis is diagnosed when calcium builds up in the valve, causing it to thicken or harden and preventing the valve from opening properly. When this occurs, it forces the heart to work harder to pump blood through the valve.
The heart can make up for aortic valve stenosis and the extra pressure for a long time. However, at some point, it becomes unable to keep up the extra effort of pumping blood through the narrowed valve, leading to heart failure.
As many as 1.5 million people in the U.S. suffer from aortic stenosis and approximately 500,000 of them have severe disease. Without a new artificial valve, half will not survive more about two years after the onset of symptoms.