Memorial Cardiac and Vascular Institute is one of the first sites in South Florida to offer Transcatheter Aortic Valve Replacement (TAVR), a groundbreaking minimally invasive therapy for severe symptomatic native aortic valve stenosis (AS). The procedure provides new hope for patients who require heart valve replacement but have been deemed inoperable for traditional open-heart surgery by a cardiac surgeon.

Approximately 250,000 people in the United States have severe symptomatic AS (narrowing of the aortic heart valve), and about one third of these patients are too sick or too old to undergo traditional replacement. Without an aortic valve replacement, 50 percent of severe AS patients will not survive more than an average of two years after the onset of symptoms.

TAVR therapy is made possible with the Edwards SAPIEN transcatheter heart valve, approved by the FDA in November 2011. The new prosthetic aortic valve is implanted via a catheter inserted in the femoral artery in the patient’s thigh and advanced to the heart using a specially designed and X-ray-guided delivery catheter. Positioned and implanted with an expandable balloon system, the entire aortic valve is replaced without incisions and without stopping the heart. The less invasive procedure provides a new lifesaving option to elderly or high-risk patients who could not tolerate open-heart surgery.

“Many of the patients who may be eligible for this procedure had given up hope for surgical treatment,” said Michele Slane, Director of Memorial Cardiac and Vascular Institute. “The new technology allows us to give patients a chance they never thought they had.” Memorial Cardiac and Vascular Institute was selected to perform TAVR due to the advanced facilities at Memorial Regional Hospital and its surgeons’ vast experience in performing aortic valve replacement (10-12 procedures each month). In addition, the Institute offers the multidisciplinary “heart team” collaboration required for the effective screening and TAVR surgery.

The Memorial Cardiac and Vascular Institute TAVR heart team comprises specialists from various disciplines, including cardiac surgeons Michael Cortelli, MD, and Juan Plate, MD; interventional cardiologists Juan Pastor-Cervantes, MD, and Luis Tami, MD; cardiologists Adam Splaver, MD, and Ralph Levy, MD; and anesthesiologist Robert Brooker, MD.

The new treatment is not suitable for everyone. To determine whether TAVR is an appropriate therapeutic option, prospective patients must undergo an extensive series of screenings and evaluations, including chest X-ray, CT, EKG, standard echo and transesophageal echo (TEE) cardiogram scans. Beginning in June, the TAVR heart team hopes to be performing the procedure for four to six patients each month.

“This procedure was unimaginable even 10 years ago,” said Michael Cortelli, MD, Chief of Adult Cardiac Surgery. “It is an example of technology that was originally developed to help the sickest patients who could not survive open heart surgery, but, as innovations continue, it will benefit healthier patients and inevitably influence the way we think about and perform cardiac surgery. Memorial Cardiac and Vascular Institute is fortunate to have the expertise and resources in place to take part in these leading-edge medical breakthroughs.”