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Today's TAVR: Helping More Patients Lead Fuller Lives

Monday, Apr 10, 2017

Research and successful outcomes of the minimally invasive TAVR have opened the door to more patients who need advanced treatment for aortic stenosis. At Doylestown Health's Heart Institute, TAVR patients benefit from the experience of a team of heart valve experts.

The combined expertise of the team at Doylestown Health's Heart Institute is resulting in excellent outcomes for patients whose aortic stenosis slowed them down and made it difficult to enjoy everyday living.

The team recently marked a milestone by performing its 100th TAVR (Transcatheter Aortic Valve Replacement) procedure. The measure known as 30-day mortality rate indicates the number of deaths within 30 days of having a procedure. The national rate for TAVR is about 7 percent. The rate at Doylestown Hospital is zero.

"Our team works exceptionally well together with a single focus – the best possible outcome for each patient," says Jennifer Harrar, CRNP, Valve Clinic coordinator.

New guidelines are opening the door to more patients eligible for TAVR.

"TAVR is a transformative technology that is allowing an ever-increasing number of patients who develop severe aortic stenosis to lead longer and fuller lives," says Doylestown Health interventional cardiologist Steven Guidera, MD.

TAVR Procedure

In the past, the only option to treat aortic stenosis, narrowing of the heart's main valve, was to have open-heart surgery to replace the diseased valve. But open-heart surgery was considered too risky for some patients, particularly the frail elderly.

Minimally-invasive TAVR is an alternative to open-heart surgery that offers patients hope for greater quality of life. The procedure is done using catheters to replace the faulty valve. Doylestown Health physicians were among the first in the region to perform TAVR in 2013.

In August 2016, the Federal Drug Administration (FDA) expanded the guidelines for which patients could receive TAVR. Today, more patients than ever before are eligible for TAVR.

"This minimally invasive treatment is now available for patients who are at intermediate or high risk for expected complications of surgical valve replacement," says Dr. Guidera.

Doylestown Health's Heart Institute built a leading program by staying current with innovative technology and offering patients a range of advanced options.

The Valve Clinic at Doylestown Health's Heart Institute combines the expertise of cardiologists, interventional cardiologists, cardiothoracic surgeons and radiologists, all working together to develop a personal treatment plan for each patient. A valve clinic coordinator collaborates with physicians to evaluate patients, coordinate tests and help arrange appointments.

The team meets regularly to discuss each patient and determine who is an appropriate candidate for the TAVR procedure. "There are many considerations for each patient and we look at all the options. Each patient is unique," says Harrar. She has seen the results of this careful consideration in the TAVR patients.

"For patients who couldn't get out of a chair, couldn't walk 10 steps, they now have a chance at a normal lifestyle," she says.

In the past, most patients who received TAVR were in their 80s or 90s, but more patients in their 70s are opting for the procedure. Recovery from TAVR is generally quicker than open-heart surgery. There are no surgical incisions, and sedation is generally used instead of general anesthesia.

"It is quite typical for a patient receiving a new aortic valve by this approach to go home within 24 hours of the procedure," notes Dr. Guidera.

Studies are underway in the U.S. to rate the effectiveness and safety of TAVR for medium- and lower-risk patients, possibly changing even more dramatically the landscape of treatment for valve disease.

TAVR is not for everyone. For some patients, physicians may recommend traditional valve replacement surgery, and Heart Institute outcomes for this type of procedure rival the best in the nation.

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About Doylestown Health's Heart Institute

Expert cardiologists and cardiac surgeons assist patients and physicians with managing risk factors for heart disease, offer advanced treatment options and provide outstanding emergency cardiac care. The multidisciplinary team at the Heart Institute is dedicated to providing the highest level of quality care and patient safety.

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