Using transcatheter aortic valve replacement to treat severe aortic stenosis.
The human heart beats about 100,000 times a day. Atria pumping, ventricles contracting, valves popping open and slamming shut, all perfectly timed by electrical signals coursing through this unflagging machine of a muscle that never gets to sleep.
It’s a lot of hard work. And a lot of room for something to go wrong.
At the Sarasota Memorial Outpatient Valve Clinic, a multidisciplinary team of interventional cardiologists, cardiac surgeons, electrophysiologists, nurse practitioners, echocardiographers, imaging specialists and heart failure specialists stands ready in case something does, equipped with the latest in medical technology to fix the problem and get the blood pumping again.
“We’re essentially mechanics,” explains Interventional Cardiologist Ricardo Yaryura, MD, FACC. But in this case, engine failure is fatal.
What is TAVR?
Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure that replaces the heart’s aortic valve, if it is diseased, damaged or otherwise not working properly.
The human heart has four valves: the aortic, the mitral, the tricuspid and the pulmonic. These valves regulate blood flow in and out of the heart. The largest is the aortic valve, which controls the flow of freshly oxygenated blood from the heart and through the aorta, where it then goes to the rest of the body. Over time, or due to a congenital heart defect, this valve can begin to narrow, making it more and more difficult for the heart to pump blood through the aorta and to the body. This is called aortic stenosis and causes symptoms like chest pain, shortness of breath and fatigue. Severe aortic stenosis is always fatal.
TAVR allows the physician to repair and replace that damaged valve without open-heart surgery.
Entering the body through a catheter in the femoral artery of the groin, the physician guides the artificial replacement valve through the blood stream to take the place of the damaged valve. “We’re actually putting a valve inside the valve,” says Dr. Yaryura. For this reason, TAVR is also referred to as Transcatheter Aortic Valve Implantation, or TAVI.
Minimally invasive, the whole process takes about 30 minutes. The patient is awake throughout and usually able to return home the next day.
Who is eligible for TAVR?
While the procedure was previously approved only for those patients considered too high-risk for open-heart surgery, the FDA approved the procedure for low-risk patients in 2019. Today, anyone suffering from severe aortic stenosis is eligible for TAVR, regardless of age or surgical risk.
Why choose SMH?
Not only is Sarasota Memorial the first hospital in Southwest Florida to receive TAVR certification from the American College of Cardiology, but the interventional cardiologists and surgeons at SMH perform 270-300 TAVR procedures every year—and the results speak for themselves.
Nationally, 10-15% of TAVR patients require a pacemaker after the procedure. At SMH, that number is as low as 4.5%. And whereas severe aortic stenosis is always fatal, the mortality rate for TAVR procedures at SMH is less than 1%.
“The more you do, the better you are,” says Dr. Yaryura. “If you have the skill, the knowledge and the experience, that one patient may not die, because you knew how to react quickly enough.”
More Information
To learn more about cardiac services at Sarasota Memorial, click here or call (941) 917-7777.
To learn more about the Sarasota Memorial Outpatient Valve Clinic, click here or call (941) 917-6968.
Written by Sarasota Memorial copywriter Philip Lederer, MA, who crafts a variety of external communications for the healthcare system. SMH’s in-house wordsmith, Lederer earned his Master’s degree in Public Administration and Political Philosophy from Morehead State University, KY, and gave his heart to Lady Macbeth.