Transcatheter Aortic Valve Replacement/Implantation (TAVR/TAVI)
TAVR or transcatheter aortic valve replacement (also known as TAVI for 'implantation' and PAVR for 'Percutaneous' -or through the leg- Aortic Valve Replacement) is a minimally invasive technique to treat severe aortic stenosis. Patients with severe aortic stenosis are often referred to Mount Sinai Hospital for a TAVR procedure, because we are the only hospital in the New York metropolitan area that can offer both TAVR treatment options available in the United States: the Edwards Sapien Valve and the Medtronic CoreValve System (clinical trial).
"This new technique of TAVR is a real game changer," notes Samin K. Sharma, MD, Director of Clinical Cardiology and Interventional Cardiology. "It provides hope to many patients suffering from aortic stenosis, who cannot undergo open heart surgery due to frailty, old age, and associated medical conditions."
Now there is great news for patients with moderate risk of aortic stenosis (not necessarily high or inoperable risk), who can receive CoreValve under the FDA approved ongoing randomized SURTAVI trial.
About Aortic Stenosis
Severe aortic stenosis is a narrowing of the aortic valve opening that allows blood flow from the heart to the rest of the body. In elderly patients, severe aortic stenosis is caused by calcium build-up on the leaflets of the aortic valve, causing them to become stiff. This reduces the pumping ability of the heart to push blood through the aortic valve to your body. The heart gets weaker increasing the chances of developing heart failure. Without treatment, about two thirds of patients who develop severe aortic stenosis die within an average of two years.
TAVR/TAVI: Implantation of a New Aortic Valve
TAVR/TAVI is a procedure to implant a new aortic valve into the heart. The duration of the procedure is about four hours with an average hospital stay of five days. During TAVR/TAVI, a cut is made on your leg to insert a sheath (a short hollow tube) that is the size of a pencil. Through this sheath, doctors will place a balloon on your aortic valve and the balloon is inflated to prepare for the new aortic valve to be placed. After the balloon is removed from your body, a transcatheter delivery system containing the new aortic valve is placed through the sheath and guided toward your diseased aortic valve using a type of X-ray called fluoroscopy.
Once the delivery system is in place, the new aortic valve is deployed within your diseased aortic valve. The new aortic valve will push the diseased valve to the side and the calcium build-up on the diseased valve acts like a glue to cement the new valve in place. Your doctor will make sure the new aortic valve is working properly by fluoroscopy and echocardiography. Once deployed, the new valve works automatically and the delivery system is removed. The physician then closes the cut in your leg.
More Options for TAVR/TAVI at Mount Sinai Hospital
At Mount Sinai, our physicians have been performing TAVR/TAVI for two years and patients from all over the world come here to seek this treatment. Mount Sinai was the first institution to implant the Medtronic CoreValve System in the United States. We are also the first hospital in New York that can implant both the Edwards Sapien Valve and the Medtronic CoreValve. These minimally invasive treatments spare patients from open-heart surgery and offer a quicker recovery and return to their daily activities.