One of the latest advancements at the UnityPoint Health Cedar Rapids Heart & Vascular Institute is the Transcatheter Aortic Valve Replacement. This new procedure is offered right here in Cedar Rapids for patients that are high risk or too sick for open-heart surgery. Transcatheter aortic valve replacement, or TAVR is a less invasive procedure that does not require open-heart surgery. This procedure involves a multi-disciplinary team of physicians from UnityPoint Health Cardiology Clinic and Physicians' Clinic of Iowa Surgical Specialists.
The TAVR procedure offers hope for heart patients with inoperable aortic stenosis (failing heart valves), that are not candidates for surgical valve replacement. TAVR valves are inserted via a catheter through the femoral artery, without requiring open-heart surgery. This minimally invasive surgical procedure repairs the damaged valve by placing a replacement valve into the aortic valve. Somewhat similar to a stent placed in an artery; this approach delivers a fully collapsible replacement valve to the valve site through a catheter. Left untreated, aortic valve stenosis can lead to serious heart problems.
In 2017 the TAVR exceeded their original goal of performing more than 60 of these procedures in September. More individuals may be identified as being appropriate for TAVR in the near future because the FDA is currently studying patients at low-risk for the standard surgical procedure. This trial represents a potentially significant expansion in the implementation of a less invasive treatment for aortic valve disease that may ultimately result in a majority of aortic valve replacements being done via this catheter-based procedure instead of surgery.
"The TAVR procedure is part of the new and advanced level of cardiac care we envisioned when we announced the Heart and Vascular Institute last year," said Todd Langager, MD, Medical Director of UnityPoint Health - Cedar Rapids Heart and Vascular Institute. "With our aging population in Iowa, this procedure has the potential to help many individuals who would otherwise be unable to have open-heart surgery. It provides lifesaving heart care closer to home. This procedure demonstrates our commitment to bringing the latest heart care technology to the Cedar Rapids community."
Aortic stenosis affects three percent of persons older than 65 and is a common heart problem caused by a narrowing of the heart's aortic valve due to excessive calcium deposited on the valve leaflets. When the valve narrows, it does not open or close properly, making the heart work harder to pump blood throughout the body. Eventually, this causes the heart to weaken and function poorly, which may lead to heart failure and increased risk for sudden cardiac death. Nearly 16 percent of Iowa's population is 65 or older and that number is expected to increase 20 percent of the state's population by 2050. A study from the Journal of the American College of Cardiology finds these patients with mild to severe aortic stenosis stand to benefit greatly from this minimally invasive TAVR procedure.
Risk factors known to influence disease progression of aortic stenosis include lifestyle habits similar to those of coronary artery disease such as hypertension, advanced age, being male, hyperlipidemia, diabetes, smoking, metabolic syndrome, and end-stage kidney disease.
The first procedures were performed in October 2016.