On Tuesday, November 13, a team of Oklahoma Heart Institute (OHI) physicians successfully performed Tulsa’s first two transapical transcatheter aortic valve replacement (TA-TAVR) procedures. TA-TAVR is a life-saving procedure for patients with severe aortic stenosis who are at too high a risk for traditional open heart surgery.
The transapical approach to TAVR was FDA approved in October 2012. Unlike transfemoral TAVR (TF-TAVR), where the heart valve is inserted through a catheter in the femoral (groin) artery, the TA-TAVR procedure involves implanting a new heart valve through a catheter inserted into the heart through a small incision between the patient’s ribs. TA-TAVR is a good option for high-risk patients with aortic stenosis whose vessels are too small or diseased to allow for a transfemoral TAVR procedure.
Elaine Andoe is one of the patients who had a TA-TAVR procedure at OHI on Tuesday. The 59-year-old Head Start teacher from Jay, Oklahoma was living with aortic stenosis, but was high-risk for traditional heart valve replacement surgery.
“I had chest wall abnormalities from previous radiation treatment, which made traditional valve replacement surgery high-risk for me, and it was determined that my vessels are too narrow for transfemoral TAVR. If it were not for the new TA-TAVR procedure, I’m afraid of what my future would have looked like,” Elaine said. “Thanks to my team at OHI, I look forward to keeping up with my three-year-old students and spending many more years with my family.”
TAVR itself is a relatively new treatment option for aortic stenosis. It was FDA-approved in November 2011 and OHI was first to introduce it to the region earlier this year. Originally approved only for patients deemed inoperable, the FDA recently expanded the indications for TAVR to include patients with aortic stenosis who are high-risk for traditional open heart surgery. This expanded indication for TAVR increases the number of eligible patients who qualify for this minimally invasive procedure.
Aortic stenosis is a disease that affects the heart’s main valve. In late stages of the disease, the valve does not properly open and close, causing the heart to work harder to push blood through the calcified aortic valve. Eventually, the heart muscle weakens, increasing the patient's risk of heart failure and death.
“As a physician, it is an honor to be the first in the region to offer TA-TAVR to patients who were left with few, if any, treatment options for their life-threatening condition,” said Dr. Kamran Muhammad, who leads Oklahoma Heart Institute’s Transcatheter Aortic Valve Replacement Program. “Oklahoma Heart Institute is committed to offering our patients the most innovative procedures and advanced technology available to improve the hearts and lives of our community.”