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Physicians at Allegheny General Hospitals Cardiovascular Institute are the first in Western Pennsylvania and among a select few in the nation to offer a new technique for minimally invasive aortic valve replacement surgery. Called Transapical Transcatheter Aortic Valve Replacement, the procedure is performed through a small chest incision that provides direct access into the heart.
Transapical TAVR is the latest Food and Drug Administration-approved treatment for people suffering from severe aortic valve stenosis, a narrowing of the aortic valve of the heart, which causes it to open and close improperly. Aortic stenosis forces the heart to work harder to push blood through the damaged aortic valve and eventually the hearts muscles weaken, resulting in heart failure and death.
Physicians at AGHs Cardiovascular Institute have been performing transfemoral TAVR procedures for the past year, an approach in which the femoral artery serves as a conduit to access the heart. Surgeons make a small incision in the groin and guide the replacement valve through the femoral artery to the heart.
Patients with smaller or diseased peripheral blood vessels, however, may not be candidates for transfemoral TAVR, said AGH cardiothoracic surgeon Stephen Bailey. In the transapical approach, a small incision is made between the ribs of the left lower chest through which the replacement valve is inserted via a catheter directly into the heart.
With direct access to the heart, the transapical approach allows us to dramatically reduce the invasiveness of this procedure compared to conventional surgical aortic valve replacement, said Bailey, who serves as director of cardiac surgery at AGH. As a result, many patients who would be at high risk for traditional aortic valve replacement surgery and who are not candidates for transfemoral TAVR now have a life-saving option that avoids the heart-lung machine.
The FDA approved TAVR for use in high-risk patients in 2012. Since then, AGH has performed 24 cases, including six using the transapical approach.
Its exciting to be able to help patients with symptomatic aortic stenosis who previously were not candidates for either conventional aortic valve surgery or the transfemoral TAVR procedure regain their health, said Dr. David Lasorda, director of AGHs Division of Interventional Cardiology.
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AGH offers minimally-invasive heart valve replacement