Transcatheter Aortic Valve Replacement

Transcatheter heart valve replacement (TAVR) is reserved for patients with severe aortic stenosis who are considered too high risk for, or cannot have, traditional forms of heart valve replacement which require open heart surgery.

  • University of Iowa Heart and Vascular Center is one of a select group of centers across the nation and the first in Iowa to offer this procedure to qualified patients.
  • UI Heart and Vascular Center is one of only two centers in Iowa performing TAVR and the only center in eastern Iowa
  • In October 2011, UI Heart and Vascular Center became the first program in the nation to receive certification for its cardiac valve program from The Joint Commission, the accreditation agency for health care organizations in the United States
  • In addition to the new transcatheter procedure, the center’s heart valve clinic offers minimally invasive surgery for heart valve repair and replacement.
  • Since opening in 2011, the UI Heart and Vascular Center TAVR Program has evaluated over 500 patients, and performed 250 TAVR procedures
    • Procedural success has been consistently higher (97%), than the national average

Transfemoral TAVR

  • During a standard TAVR procedure, the damaged heart valve is replaced with a prosthetic valve
  • This new technology uses a catheter inserted through a small incision in a patient’s thigh that travels through blood vessels and can be used to replace a person’s failing heart valve in the aortic artery
  • A specially trained multidisciplinary TAVR team including cardiac surgeons, interventional cardiologists, and cardiac imaging specialists performs the procedure
  • With TAVR, aortic stenosis patients who were too high risk for traditional surgery can be successfully treated and enjoy a faster recovery
 
Transfemoral TAVR

Transapical TAVR

  • Doctors at University of Iowa Heart and Vascular Center are among the first in the nation to offer Transapical TAVR, a new minimally invasive treatment for patients with severe aortic stenosis (narrowing of the heart's aortic valve)
  • UI Heart and Vascular Center is the first in Iowa to successfully perform the transapical TAVR procedure
  • In the standard TAVR procedure, the new valve is inserted on a catheter from the patient’s thigh
    • However, some patients have disease of the leg blood vessels that prevents this approach
    • Using the transapical approach, a replacement valve is inserted through a small incision on the lower left side of a patient's chest, under the rib cage
    • The transapical method allows University of Iowa physicians to extend the same life-saving valve replacement benefits to even more patients who cannot have traditional valve surgery
    • Similar to the standard TAVR procedure, the transapical approach allows patients to recover more quickly than with traditional surgical valve replacement

 

 
Trans Apical Placement Procedure

UI Heart and Vascular Center offers the most experienced physicians and most comprehensive transcatheter valve program in the entire state of Iowa and western Illinois. Please call us at 319-384-6245 or email the TAVR program for questions, additional information, to ask about a TAVR clinical trial, or to refer a patient.

The TAVR Heart Team

  • The safety and effectiveness of the Edwards SAPIEN Transcatheter Heart Valve were evaluated in a randomized, controlled pivotal study called The PARTNER Trial
    • This rigorous study established the clinical evidence necessary for FDA approval, making it available to patients with severe, symptomatic native aortic valve stenosis unable to undergo traditional open-heart surgery
    • The name of the trial signifies the important partnership between cardiac surgeons and interventional cardiologists who were brought together to collaborate in the evaluation, treatment and follow-up care of patients using a multi-disciplinary, Heart Team approach
  • The partnership between the cardiac surgeon and interventional cardiologist establishes the core of the TAVR Heart Team—a care team comprised of specialists from various disciplines that work together to ensure optimal patient outcomes
  • This multidisciplinary approach to patient care is essential in TAVR, as each specialist contributes an important area of expertise that plays an integral role in the collective care process

Transcatheter Heart Valve Team

The cardiac surgeon determines the most appropriate candidates for TAVR, and plays a critical role in ensuring optimal outcomes by offering their surgical expertise as needed during the transfemoral TAVR procedure.

An interventional cardiologist (IC) works closely with a cardiac surgeon in the evaluation of potential candidates for TAVR. ICs perform transfemoral TAVR in a cardiac cath lab or hybrid operating room (OR) aided by imaging equipment to assist with optimal valve delivery and placement.

An anesthesiologist is responsible for ensuring safe delivery of anesthesia before and during the procedure, monitoring the patient during the procedure and overseeing post-procedure care.

An echocardiographer uses ultrasound technology to examine and evaluate the function of the heart including valve function and blood flow.

The cath lab and/or staff assist with device as well as room preparation, and closely monitor the patient and procedure environment both during and after the procedure.

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Care Team

  • Alyssa Speight, RN, BSN