The “gold standard” treatment for severe aortic stenosis is surgical
aortic valve replacement. This therapy has a proven track record of
relieving symptoms and helping patients live longer and feel better.
However, the procedure requires opening the chest and placing a patient
on a heart-lung machine during surgery. Advanced age, a history of heart
disease, frailty, and other health issues are all factors that may limit
a patient’s ability to undergo surgical aortic valve replacement.
The Edwards SAPIEN Heart Valve
The SAPIEN heart valve is made
of cow heart tissue (valve
leaflets) sewn onto an
expandable stainless steel frame
(stent). During the TAVR
procedure, the valve is
collapsed down to roughly the
diameter of a pencil and then
advanced to the heart by way of
a special tube (catheter).
SAPIEN transcatheter heart valve
SAPIEN transcatheter heart valve
Edwards SAPIEN transcatheter
heart valve open
Transcatheter aortic valve replacement (TAVR) may be an option for some
patients who cannot have surgery or who are considered at high risk for
surgery. The Edwards SAPIEN transcatheter heart valve is the first TAVR
therapy approved for use in the United States. TAVR therapy with the
SAPIEN valve allows the diseased aortic valve to be replaced without an
incision in the chest or the need to be placed on a heart-lung machine.
Lankenau Medical Center is among the first hospitals in the United
States to offer TAVR using the newly FDA-approved transfemoral
approach. With this approach, a new valve is implanted using a long
flexible tube (catheter) that is inserted into a blood vessel in the
upper thigh. Lankenau’s expertise in heart valve surgery and
catheter-based treatments of heart problems were important factors in
being selected to offer TAVR.
At Lankenau, TAVR procedures are performed in a specially designed
“hybrid” treatment room that combines the capabilities and equipment of
both a cardiac catheterization lab and an operating room. Advanced
imaging equipment is available to ensure that the new valve travels
safely to the heart and is placed precisely. The TAVR team combines the
skills and expertise of cardiac surgeons and interventional
cardiologists. Meet the
specialists on our TAVR team.
After the procedure, patients are moved to the cardiothoracic intensive
care unit (CTICU) and then to surgical step down units for careful
monitoring and post-procedure care under the direction of the Valve
Clinic team. Patients may be hospitalized for four to seven days after
the procedure. All patients are followed closely through the healing and
recovery process and during rehabilitation.
The TAVR Procedure
During the TAVR procedure, a new valve is implanted in the heart using a
long flexible tube (catheter) that is inserted into a blood vessel in
the upper thigh.
An estimated 25,000 TAVR procedures have been performed worldwide with
the Edwards SAPIEN heart valve. The therapy was approved based on
results from an international clinical study called the PARTNER trial.
How Effective Is TAVR?
aim of the PARTNER trial was to study the effectiveness of transfemoral
TAVR therapy with the SAPIEN heart valve. In one part of the study
(called “Cohort B”), patients with severe inoperable aortic stenosis
were divided into one group treated with TAVR and another treated with
“standard therapy” (medicines, balloon valvuloplasty, or both). After 2
years, TAVR was associated with:
A nearly 25 percent decrease in death from any cause
A 50 percent decrease in heart-related death
A significant improvement in symptoms (almost twice as many
people had no or mild symptoms at 2 years)
For more information, call 1.866.CALL.MLH.