Breakthrough in aortic valve treatment
Transcatheter procedure eliminates surgery for some.
Cardiologists are increasingly enthusiastic about a new technique for replacing failing aortic valves without open-heart surgery. As discussed in the February 2012 Harvard Heart Letter, transcatheter aortic valve replacement (TAVR) lets a new valve be delivered to the heart through a catheter inserted in an artery in the groin. In clinical trials at Brigham and Women's Hospital, Massachusetts General Hospital, and 24 other academic medical centers, TAVR was clearly beneficial in very sick people with damaged aortic valves who were poor candidates for surgery. Interest in the technique continues to grow, since the results of TAVR in healthier people with valve disease are encouraging.
"TAVR is the most exciting therapeutic innovation in cardiovascular disease in the past 20 years. I have patients whose downhill course has been completely reversed by this technology," says Dr. Andrew Eisenhauer, director of the interventional cardiovascular medicine service at Brigham and Women's Hospital and an assistant professor at Harvard Medical School.
Replacing an aortic valve without surgery
The no-surgery aortic valve assembly approved by the FDA is crimped onto a deflated balloon at the end of a flexible catetheter. Inserted into the leg's femoral artery (A), the catheter is guided through the aorta into the opening of the failed aortic valve (B). Inflating the balloon expands the new valve and wedges it into place (C).