University of Iowa Heart and Vascular Center performs 1,000th TAVR procedure

Herb Ohrt (seated) with cardiologist Phillip Horwitz, MD, Lana Goldsmith, ARNP, and Angela Kipp, RN. This photo was taken before the COVID-19 pandemic. UI Health Care staff follow our most current guidance to wear the appropriate PPE when seeing patients.

The region’s most experienced TAVR program serves more patients with severe aortic stenosis than any other center in Iowa.

Herb Ohrt didn’t think getting the mail would ever be this difficult.

With the aortic valve in his heart seriously damaged by a condition called stenosis, Herb, 73, barely had the strength to make the walk to his mailbox.

“It’s about a block away,” says Herb, of Iowa City, Iowa. “I’d go to get the mail and I’d be huffing and puffing.”

In January 2020, UI cardiologist Phillip Horwitz, MD, and UI cardiac surgeon Sharon Larson, DO, replaced Herb’s failing aortic valve with an artificial valve by using a minimally invasive procedure called transcathether aortic valve replacement (TAVR). In a TAVR procedure, the aortic valve is replaced without open-heart surgery. Instead, the new valve is placed in the heart with a catheter that is advanced from a small incision in the leg through the patient’s arteries.

Without the need for surgery, patients can recover faster. Some leave the hospital the day after the procedure.

Three weeks after his TAVR procedure, Herb visited Horwitz for a checkup, but Herb admitted that he had already conducted his own “test” of the new valve.

“It’s incredible,” Herb says. “I walked an easy six blocks and had no shortness of breath, fatigue, or pain.”

Iowa’s leading TAVR program hits a milestone

More than 1,000 patients have received their TAVR treatment at the UI Heart and Vascular Center, which was the first center in the nation to be certified a Joint Commission-accredited Valve Program

Horwitz, who serves as medical director of the UI’s structural heart disease program, says patients trust UI Health Care’s TAVR team because of its deep experience in performing the procedure for nearly a decade.

“We started in 2011, and in our first seven years, we did 500 procedures,” Horwitz says. “Two years later, we’ve done 500 more. And our success rate is 99% and has remained consistently higher than the national average. With our track record, our patients come to us confident that we’ll provide them with the best care available.”

Making TAVR the right choice for even more patients in Iowa and beyond

TAVR was originally intended only for patients for whom open-heart surgery would be too risky. But as the procedure becomes safer and more effective, more patients would like to consider TAVR as a viable option instead of surgery—even those who qualify for open-heart surgery.

The University of Iowa was the only site in Iowa that participated in a recent international clinical trial of TAVR in patients whose open-heart surgery risk is low. The procedure used a balloon-expandable replacement valve in low-risk patients to determine whether a valve replaced with TAVR could be more beneficial than a valve replaced with surgery.

The results of the trial were released last April, and Horwitz, who served as the UI’s principal investigator on that trial, says they were very encouraging.

“A year after having the procedure, the patients in that trial who had TAVR instead of surgery had significantly lower combined rates of death, stroke, and rehospitalization,” Horwitz says. “It really points to the effectiveness of TAVR, which is great news for all patients who need to have their aortic valve replaced.”

UI cardiologists are also the first in the state to use a new procedure called BASILICA, a TAVR technique for managing challenging heart structure. For those patients, TAVR alone would only create new and potentially fatal complications. By offering BASILICA, UI cardiologists are extending the option of life-changing TAVR care to patients who had no choice but surgery before. Only highly experienced centers like the University of Iowa can manage complex patients who need valve treatments.

The UI Heart and Vascular Center’s highly collaborative team includes heart surgeons, interventional cardiologists, heart imaging specialists, and anesthesiologists. Every aortic stenosis patient receives a complete evaluation by heart surgeons and a cardiologist. After testing, the team confers to determine the best treatment for that patient.

UI Health Care is keeping all patients safe with isolation of COVID-19 patient care areas, face coverings for all patients and visitors, face shields and masks for all employees, health screening at all entrances, enhanced cleaning of high touch surfaces, reduced seating in public spaces, hand hygiene stations, and more.

Learn more about the UI Heart and Vascular Center’s TAVR program.