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St. Mary Cardiac Team Now Offers Transaortic Approach for TAVR

Advances in Transcatheter Aortic Valve Replacement will benefit a greater number of patients


LANGHORNE, Pa., August 12, 2014
– Cardiac specialists at St. Mary Medical Center say that advances in the innovative TAVR procedure continue to be made and that is good news for patients with heart-valve disease. Transcatheter aortic valve replacement (TAVR) is a minimally invasive treatment option for patients with advanced aortic stenosis who cannot tolerate open-heart surgery to have a heart valve replacement. Recent advances in TAVR procedures performed at St. Mary include the use of a third point of access for the procedure - a transaortic approach - and a smaller delivery system for the placement of the new heart valve.

“TAVR has been a real life-saver for patients who have heart valves damaged by aortic stenosis but due to various factors are not considered candidates for open-heart surgery,” says George Heyrich, MD, a board-certified interventional cardiologist and medical team lead for TAVR at St. Mary. “TAVR continues to be a breakthrough procedure for helping patients who previously had no other treatment options available, and St. Mary continues to be a leader in this field. Physicians here were the first in Bucks County to perform TAVR, and because of their talent, skill and experience, our cardiac surgeons and interventional cardiologists also are among the first in the region to use the transaortic approach.”

Transaortic TAVR is performed through a small incision in the breastbone right near the heart. Then, similar to the transfemoral approach through in incision in the upper thigh and the transapical approach through an incision between the ribs in the side of the chest wall, a balloon-expandable heart valve is precisely positioned within the heart using a catheter delivery system.

Aortic stenosis is a potentially life-threatening progressive narrowing of the valve that controls blood flow to the heart. Quality of life for these patients is severely compromised and just a few steps can leave them breathless. Frequent symptoms also include chest pain, rapid or irregular heartbeart, shortness of breath, and extreme fatigue. Prior to FDA-approval of TAVR, open-heart surgery was the only way to replace heart valves damaged by aortic stenosis. The additional TAVR access points, a smaller catheter delivery system and an increasing number of valve sizes is expanding the number of patients eligible for TAVR who also benefit from a less invasive procedure and shorter recovery time.

“Patients who undergo TAVR at St. Mary have to be considered high risk for surgery. When we take patients through screening process, which includes a CT scan, we look at the caliber of the vessels in the patient’s legs to see if the transfemoral approach, which is our first preference, is a viable option. If those vessels are too small to allow transfemoral access, we then look at the other alternatives - transapical or transaortic access. That’s the benefit of having three different TAVR access points — and that’s what sets the St. Mary TAVR program apart from other heart centers,” says Dr. Heyrich.

The TAVR program at St. Mary is supported by a dedicated patient care team that is highly experienced in managing the complex medical needs of high-risk heart patients. This team includes interventional cardiologists, cardiothoracic surgeons, nurse practitioners, and certified rehabilitation professionals.

As part of its commitment to providing the highest-quality patient care and to practicing evidence-based medicine, St. Mary Medical Center is one of 318 U.S. hospitals — and one of only 24 Pennsylvania hospitals — taking part in a national registry of TAVR patient outcomes. The TVT Registry™ is a benchmarking tool developed by The Society of Thoracic Surgeons and the American College of Cardiology to monitor the safety and efficacy of this new procedure for the treatment of aortic stenosis.

For information about TAVR and eligibility guidelines at St. Mary Medical Center, contact Kelly Norton, CRNP, TAVR Coordinator at St. Mary, at 215.710.6026 or knorton@stmaryhealthcare.org For a referral to a St. Mary cardiologist, call 215.710.5888 or search our online medical staff directory at www.StMaryHealthcare.org/physicians.