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Heart Valve Treatment Options Expand

​​​​​​​​​​A new option is available for patients needing a heart valve replacement who cannot have op​en-heart surgery. The transcatheter aortic valve replacement (TAVR) may offer a treatment option where none existed.

The U.S. Food and Drug Administration (FDA) recently approved the first artificial heart valve that can replace a diseased aortic heart valve using a catheter-based procedure. Marshfield Clinic/Ministry Health Care’s heart care program at Ministry Saint Joseph’s Hospital in Marshfield is among the first three programs in Wisconsin approved to provide TAVR.

Healthy heart valves keep the blood moving as easy as possible through the heart. Sometimes, the heart valves don’t open or close properly, disrupting the normal blood flow through the heart and the rest of the body. When the heart valves do not open properly, it is called stenosis. In older patients, severe aortic stenosis, caused by a build-up of calcium, narrows the valve opening.

“During the TAVR procedure, a catheter is used to pass a new valve through the blood vessels into the damaged valve while the heart is still beating,” said Cardiovascular and Thoracic Surgeon Hope Maki, M.D., Marshfield Clinic Marshfield Center. “The valve is then released and ballooned or expanded into place. It immediately begins working.”

For most patients who have aortic valve stenosis, treatment usually is valve replacement surgery. “But some patients may not be candidates for open heart surgery,” said Dr. Maki. These patients may have had one or two previous heart surgeries or have medical conditions such as poor kidney or heart function, frailty and advanced emphysema. “We look at the patient in total to decide if TAVR is the best option,” she said.

To-date the new valve (made from animal tissue), manufactured by Edwards Lifesciences, is the only FDA-approved artificial valve for patients who are too sick for open-heart surgery. Approval was based on results from the PARTNER (Placement of AoRTic traNscathertER valves) Trial, the world’s first randomized clinical trial of the new valve.

“The PARTNER Trial studied the sickest patients. No surgical treatment options for these patients were available,” said Interventional Cardiologist Milind Shah, M.D.​, Marshfield Clinic Marshfield Center. “The research showed great improvement in life expectancy and quality of life for patients who underwent the TAVR procedure. The survival rate in this group of patients improved 20 percent.”

The TAVR procedure expands the number of patients who may be treated for aortic valve disease, but it is not for everyone. Each patient is seen by a team of heart valve disease specialists to make sure the best treatment option is offered and to ensure the patient and his or her family understand the option.

Marshfield Clinic offers comprehensive services throughout the Clinic system for diagnosing and treating heart valve disease. For more information on the TAVR procedure, or to make a self-referral for evaluation, call 1-866-623-4728​.​