Heart - Cardiology & Cardiovascular Surgery

Transcatheter Aortic Valve Replacement - Implantation

"This new technique of TAVR is a real game changer," notes Samin K. Sharma, MD, Director of Clinical and Interventional Cardiology, and President of Mount Sinai Heart Network. "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."

Transcatheter aortic valve replacement (TAVR) and transcatheter aortic valve implantation (TAVI) are minimally invasive techniques designed to treat coronary artery disease, and particularly severe aortic stenosis. The Mount Sinai Health System, specifically The Mount Sinai Hospital, is the only hospital in the New York metropolitan area that offers both types of TAVR treatment options (Edwards Sapien Valve and Medtronic CoreValve System, which is in clinical trial) for these types of diseased aortic valves.

We use the TAVR and TAVI procedures to implant new aortic valves into the heart. The procedures take about four hours and you usually spend approximately five days in the hospital.

The Procedure

To perform either procedure, we make a cut on your leg to insert a sheath (a short hollow tube) that is about the size of a pencil. We use this sheath to place a balloon on your aortic valve. Then we inflate the balloon to prepare a space for the new aortic valve. After we remove the balloon, we replace it with a transcatheter delivery system containing the new aortic valve, using the sheath as a pathway and guiding it along with a type of X-ray called fluoroscopy.

Once in place, we deploy a new aortic valve into your diseased aortic valve. This new valve pushes 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. As soon as it is in place, the new valve will start to work. We use fluoroscopy and echocardiography scanning techniques to make sure the new aortic valve is working properly. Then we remove the delivery system and close the cut in your leg.