Structural Heart/Valve Clinic
Valve disorders affect the valve's ability to regulate blood flow through the heart. A valve problem can occur when a valve is not opening appropriately (stenosis), or the valve is insufficient (regurgitation).
The Southcoast Valve Clinic includes expert cardiovascular surgeons and cardiologists who deliver the highest quality of heart care to patients with complex valve disorders.
The valve clinic team performs a full evaluation to determine your best treatment plan for valve repair or valve replacement.
Some common valve disorders include:
- Aortic stenosis.
- Aortic regurgitation.
- Mitral stenosis.
- Mitral regurgitation.
- Tricuspid regurgitation.
Structural Heart Program
The Structural Heart Program offers multidisciplinary services to care for the complex needs of patients with structural heart disease. The program offers minimally invasive treatment for patients with valve disease, congenital heart disease, and other cardiac issues who may not be able to have open heart surgery.
Our cardiologists represent a variety of heart specialties and work together with your referring physician to develop a specialized treatment plan. Physicians have access to the latest technology to offer patients the best possible care.
TAVR is one of the many advanced treatment options that is available through Southcoast’s cardiovascular services. This procedure is used to treat aortic stenosis.
Open-chest surgical AVR is the gold standard and an effective treatment of severe aortic stenosis and has been proven to provide symptomatic relief and long-term survival in adults. During the procedure, the damaged “native” heart valve is removed and replaced with a prosthetic valve. Open-chest surgery is recommended for virtually all adult aortic stenosis patients who do not have other serious medical conditions.
For patients who have been deemed inoperable or high risk for traditional open-chest surgery, a procedure called transcatheter aortic valve replacement (TAVR) is now available as a treatment option.
The transcatheter heart valve is approved by the U.S. Food and Drug Administration (FDA) as a therapy for patients with severe symptomatic native aortic valve stenosis who have been determined by a heart team that includes an experienced cardiac surgeon and cardiologist to be inoperable or high risk for open-chest surgery to replace their diseased aortic heart valve. Patients who are candidates for this procedure must not have other co-existing conditions that would prevent them from experiencing the expected benefit from fixing their aortic stenosis.
This procedure enables the placement of a balloon-expandable heart valve into the body with a tube-based delivery system (catheter). The valve is designed to replace a patient’s diseased native aortic valve without traditional open-chest surgery and while the heart continues to beat – avoiding the need to stop the patient’s heart and connect them to a heart-lung machine which temporarily takes over the function of the heart and the patient’s breathing during surgery (cardiopulmonary bypass).
For the catheter-based procedure, the valve is delivered through an incision in the leg (transfemoral procedure) or through an incision between the ribs and then through the bottom end of the heart called the apex (transapical procedure).
The structural heart team will conduct a comprehensive evaluation to determine whether the TAVR procedure is an appropriate option based on each individual patient’s needs. In certain cases, TAVR may not be an option because of co-existing medical conditions or disease processes that would prevent the patient from experiencing the expected treatment benefit or because the risks outweigh the benefits. For those who are candidates for TAVR, this therapy may provide relief from the often debilitating symptoms associated with severe symptomatic native aortic valve stenosis.
As with most therapies, there are risks associated with the procedure. TAVR is a significant procedure involving general anesthesia, and placement of the Edwards SAPIEN valve is associated with specific contraindications as well as serious adverse effects, including risks of death, stroke, damage to the artery used for insertion of the valve, major bleeding, and other life-threatening and serious events. In addition, the longevity of the valve’s function is not yet known.
The TAVR Team at Southcoast
Adam Saltzman, MD
Christopher Abadi, MD
Mitchel Sklar, MD
James Fingleton, MD
Iraklis Gerogiannis, MD
Franklin Schneider, MD
Christine Rooney, PA
Elizabeth Yokell, RN
More about TAVR
- The first successful TAVR procedure was performed in France on April 16, 2002, by Alain Cribier, M.D., University Hospital Charles Nicolle in Rouen, France.
- The Transcatheter Heart Valve is FDA-approved for the treatment of both inoperable and high-risk patients with severe, symptomatic calcified native aortic valve stenosis in need of an aortic valve replacement.
- In October 2012, the FDA approved an expanded indication to enable the treatment of high-risk patients. The FDA also approved a new delivery method called the transapical procedure for high-risk patients without suitable access through their leg artery. During this procedure, the valve is inserted via an incision between the ribs and then through the bottom end of the heart called the apex.
- The PARTNER Trial was the world’s first randomized controlled trial of TAVR and, importantly, cardiac surgeons and interventional cardiologists were brought together in a clinical trial to collaborate to evaluate and treat patients.