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Published on November 23, 2016

Cone Health Doctors Help Develop Valve Replacement Program

A new approach to aortic valve replacement offers a safer, faster procedure than the open-heart surgery that this new treatment is replacing.

A new heart procedure offering an effective and minimally invasive way to treat heart valve problems is showing excellent results at Cone Health’s Heart and Vascular Center.

Severe aortic stenosis, a common heart valve problem, typically causes fatigue, shortness of breath and dizziness. This is more common in older patients because it’s the result of thickening and calcification of arteries, and that usually happens slowly over many years. Symptoms come on gradually and most often start with a decreased ability to exercise. If untreated, aortic stenosis can result in chest pain and, ultimately, heart failure.

For many years, the only way to replace a failing heart valve was open-heart surgery to remove the old valve and replace it with a new one. Although open-heart surgery works well, there’s a much less invasive way to replace a heart valve: a trans-catheter aortic valve replacement, or TAVR.

TAVR is less invasive

Clarence Owen, MD, cardiovascular

surgeon with Cone Health Medical

Group HeartCare and co-director

of the Multidisciplinary Heart Valve

Clinic at Cone Health’s Heart and

Vascular Center.

TAVR (pronounced “tah-vuhr”) replaces the old valve with a new one without the need for open-heart surgery. Doctors insert the new valve via an artery in the patient’s groin and follow the artery to the heart, where they push the old valve out of the way and fix the new valve in place.

“This faster and less-invasive procedure often produces better results,” says Clarence Owen, MD, co-director of the Multidisciplinary Heart Valve Clinic at Cone Health’s Heart and Vascular Center.

“Due to the far less-invasive nature of TAVR, patients recover very quickly,” he says. “They’re out of the hospital in two or three days and back to normal activity within a week or two, which is very different from open-heart surgery.”

TAVR use is expanding

TAVR has been used in Europe for almost 10 years and in the U.S. since November 2012. The FDA recently issued a statement, based on clinical evidence gathered at Cone Health hospitals and at other medical centers, which expanded the criteria for use of this lower-risk alternative to open-heart surgery. Previously approved only for patients at high or greater risk for death or complications during surgery, the valves used in the TAVR procedure are now approved for patients who are at intermediate risk for death or complications associated with open-heart surgery. Owen and his fellow co-director of Cone Health’s Multidisciplinary Heart Valve Clinic, cardiologist Michael Cooper, MD, have performed more than 100 of these operations in the past two years. Both physicians are enthusiastic about TAVR.

“This is a transformative therapy that everyone is excited about,” Cooper says.

Michael Cooper, MD, cardiologist

with Cone Health Medical Group

HeartCare and co-director of the

Multidisciplinary Heart Valve Clinic

at Cone Health’s Heart and Vascular

Center.

“In the beginning we had some reservations, and over time we’ve found that TAVR is safer and better than any of us dreamed it would be. TAVR has really improved how we treat patients with this disease.”

“This is what everyone is talking about,” Owen says. “We’re going to meetings and conferences all the time to present and discuss research. Knowledge around TAVR spreads like wildfire.”

Team approach accompanies procedure

It’s not just about the procedure and the device. TAVR has changed the way medical professionals treat patients, and the Cone Health Heart and Vascular Center is on the forefront of this movement. The approach is now multidisciplinary: Heart care physicians with different kinds of expertise work closely with a team of nurses and other care providers, each using their own skill set to provide the best patient care possible.

“Our team at the Cone Health Heart and Vascular Center comprises anesthesiologists, radiologists, interventional cardiologists and cardiac surgeons,” says Cooper. “We have a nurse navigator as well, a key team member who helps patients and their families work through the process and follow-up.”

“TAVR has forced a new way of thinking that improves the way we approach caring for patients with advanced cardiac disease,” says Owen. “We’ve built a world-class team that comes up with the best way to treat each patient. You can’t get that at a smaller hospital. The Cone Health Heart and Vascular Center has the knowledge, the specialists and the facility to make each TAVR procedure a success.”