UCLA Health ranks as one of the top 3 hospitals in the nation - according to a U.S.News & World Report survey. Our cardiology and heart surgery program consistently ranks as one of the top in the nation.
Aortic valve stenosis is a form of heart disease in which the valve that regulates the flow of blood from the heart is prevented from opening fully. This can lead to chest pain or chest tightness, heart palpitations, fatigue and shortness of breath, especially with exertion.
While physicians have had great success in treating aortic valve stenosis by replacing the faulty valve with a mechanical one or a valve made from animal tissue, some patients have not been candidates for this procedure because they are not healthy enough for open-heart surgery. These patients may benefit from a new replacement valve that can be implanted through a small incision in the groin or between the ribs, eliminating the need for a large incision in the chest.
The U.S. Food and Drug Administration (FDA) has recently approved the transcatheter aortic valve replacement (TAVR) for appropriate patients with aortic valve stenosis who are not candidates for open surgery to replace their natural aortic valve. The procedure resembles a balloon angioplasty, in which a catheter - a long, flexible tube - is threaded through an artery and a balloon device on the end inflates to help open up a narrowing in an artery in the heart. In the case of TAVR, the replacement valve collapses to a very small diameter and is crimped onto the balloon device. The surgeon positions the replacement valve inside the patient's natural aortic valve and inflates the balloon. This causes the replacement valve to expand, pushing the faulty valve aside. The replacement valve begins to function as soon as the balloon catheter deflates to permit the flow of blood.
Patients usually enjoy immediate benefit from the procedure in terms of improved blood circulation. Because the replacement valve is placed using minimally invasive techniques, patients usually experience a much more rapid recovery than they would from a traditional, open-heart valve replacement.
The new device is initially being made available at centers whose experience in doing similar interventional cardiology procedures best qualify them to perform the new TAVR procedure. UCLA's team of experts includes interventional cardiologists, cardiothoracic surgeons, anesthesiologists, echocardiographers and a heart-lung machine team. UCLA physician are currently evaluating patients as candidates for TAVR.
In a recent research trial, a group of aortic valve stenosis patients receiving only medical therapy had a one-year survival rate of 50 percent; TAVR was shown to improve one-year survival to 70 percent. "The initial rollout is for patients considered to be too high a risk for surgery," explains Jonathan Tobis, M.D., clinical professor of cardiology and director of Interventional Cardiology at UCLA. "The expectation is that this will eventually be used for a wider population."
In addition to improving longevity, by improving the circulation of oxygenated blood the new device can reverse some of the limitations that their heart disease has caused these patients. "We expect to see substantial quality-of-life gains from the new procedure," states Richard J. Shemin, M.D., chief of Cardiothoracic Surgery at UCLA. "Many patients who were formerly bedridden may be able to resume some of the activities of daily life."
UCLA is actively evaluating patients as candidates for TAVR. For more information or to arrange an evaluation, please call the appointments number below.
(310) 825-9011 UCLA TAVR coordinator
TAVR@mednet.ucla.edu
Aksoy, Olcay MD
Cardiovascular Disease
Kwon, Murray MD
Thoracic Surgery; Transplant Surgery
Shemin, Richard MD
Thoracic Surgery; Transplant Surgery
Suh, William MD
Cardiovascular Disease
Tobis, Jonathan MD
Cardiovascular Disease
Vorobiof, Gabriel MD
Cardiovascular Disease
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