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Clinical trial achieves major success in trans-catheter aortic valve replacement

July 19, 2012 posted by Carissa D. Etters

GREENVILLE – Surgeons and cardiologists at the East Carolina Heart Institute at Vidant Medical Center and East Carolina University achieved a first in North and South Carolina. On June 20, 2012 they inserted a new heart valve through the apex or tip of a patient’s heart. 
The procedure was performed with a catheter-based valve and is generally referred to as trans-catheter aortic valve replacement, or TAVR for short.   TAVR procedures are often performed by inserting the valve through an artery in the leg. However, many patients have small or diseased arteries that prevent this approach.  The trans-apical approach uses a mini-incision into the tip of the heart through the left chest.  This makes it possible to offer this life-saving therapy for those whose leg arteries are too small for TAVR devices.
"This development in TAVR gives us the full spectrum of options for all patients with valve disease,” Tan said. “This patient did not have many alternatives to relieve her distressing problems before she came to the East Carolina Heart Institute. Breathing difficulties and intense leg pains kept her awake at night. We helped the patient by doing whatever it took: from giving medications, to putting stents in her legs, to offering the most innovative valve technology,  to restore her comfort and independence."  
Benefits of TAVR include faster recovery and less pain than traditional valve replacement surgery. Since the start of the trial, the team has performed 11 successful TAVR
TAVR is considered to be less invasive than a traditional valve-replacement operation, which involves open-heart surgery and the use of a heart-lung machine. Candidates for TAVR are either not good candidates for the traditional surgery or might be considered too weak or too old to undergo the surgery. The newer version of the valve is smaller and less traumatic, and is currently being tested in the second phase of the PARTNER (Edwards Life Sciences, Inc and FDA) trial at the East Carolina Heart Institute.
 “The trans-catheter approach to aortic valve insertion is changing the way we treat aortic stenosis, which affects so many elderly people in this country,” said Dr. Curtis Anderson, cardiothoracic surgeon and associate professor of cardiovascular sciences at ECU. “Many patients prior to TAVR had no options at all, and many were never referred for evaluation.  With the addition of the trans-apical approach at the East Carolina Heart Institute, we are broadening the range of people who are candidates for this therapy.”
The patient was an 83-year old woman from Halifax County who was discharged only five days after getting a new valve. The TAVR team was led by East Carolina University physicians Drs. Anderson and Walter Tan, who is also associate director of the Heart Institute cardiac catheterization labs.
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