A newly approved procedure that allows a heart valve to be replaced in patients who cannot tolerate open-heart surgery is now available in Tulsa.
The first two procedures in the area were performed last week at the Oklahoma Heart Institute. Doctors at St. Francis Health System are also preparing to perform what is called transcatheter aortic valve replacement, or TAVR.
"They went exactly as we expected and they (the patients) both were walking the day after the procedure," said Dr. Kamran Muhammad, an interventional cardiologist at Oklahoma Heart Institute.
TAVR involves the replacement of a calcified and stiffened aortic valve that has restricted blood flow to the heart, said Dr. Douglas Ensley, an interventional cardiologist at St. Francis.
"Instead of pumping blood through a garden hose, it's like pumping blood through a straw," he said.
A catheter is inserted through the femoral artery in the groin and a balloon is sent through the artery to the chest, to open up the aortic valve. A replacement valve made of cow tissue is then inserted and inflated in place of the diseased valve, pushing it out of the way.
Muhammad said the procedure is only approved for people who can't have open heart surgery because they are too frail or have other diseases that prohibit it.
"Prior to this being available there was really no option for these patients," he said.
Ensley said open heart surgery is still the only and best option for most patients who need a valve replaced. TAVR is for patients who can expect to live several more years and be relatively active. Patients can't chose TAVR because they would prefer it.
Eventually, however, it may be approved for more patients, he said.
"That will change gradually as time goes on," he said.
Recent studies have shown patients who undergo TAVR live longer, have a better quality of life and spend less time in the hospital than patients who received standard treatment.
For patients who needed a valve replacement but were still candidates for open heart surgery, TAVR had similar rates of success to the surgery, researchers found.
The procedure takes about an hour and a half and is done under general anesthesia. It was approved by the FDA last fall. Risks include stroke, injury to blood vessels and possible damage to the heart's electrical system.
TAVR is slightly more expensive than open heart surgery but is still cost effective, partly because of the shorter hospital stay, Muhammad said.
Medicare recently agreed to pay for the procedure in qualified patients, he said.
Source: Tulsa World, May 17, 2012