Newest Advance in the Evolution of Minimally Invasive Heart Surgery
A team of cardiothoracic surgeons, interventional cardiologists and anesthesiologists at the Cooper Heart Institute recently achieved a medical milestone by performing transcatheter aortic valve replacement, or TAVR, under conscious sedation for the first time. Since then, the team has successfully performed several additional cases using this method.
Cooper is one of a few select heart centers in the region to perform TAVR under conscious sedation, rather than general anesthesia — for those patients who qualify. TAVR, a nonsurgical alternative to open-heart surgery, is an advanced method for the treatment of severe aortic stenosis Cooper was one of the first hospitals in the Delaware Valley to offer the TAVR procedure and recently performed its 200th case.
The TAVR procedure involves feeding an artificial valve by catheter through an artery in the groin or the chest to the heart. Once placed in the correct position, the artificial valve is opened and begins to function.
“This is a game changer,” according to Janah Aji, MD, FACC, Director of the Cooper Cardiac Catheterization Lab, who performed the first conscious-sedation TAVR procedure. “Patients with aortic stenosis are generally elderly and have other health conditions that make them too weak to undergo open-heart surgery. Even general anesthesia may be a significant incremental risk in some patients, thus the potential option of sedation is welcome.” Under conscious sedation, the patient is awake and able to communicate with the physicians during the procedure. The lighter anesthesia can mean less recovery time and a shorter hospital stay.
“We are very excited about this newest milestone,” said Perry J. Weinstock, MD, FACC, Director of the Cooper Heart Institute. “Cooper Heart Institute is a regional leader, continually offering new procedures and advances to our comprehensive adult cardiovascular program that includes a wide-range of non-invasive, invasive, and surgical diagnostic and therapeutic options for patients in South Jersey.”
An age-related disease that affects approximately 300,000 Americans, aortic stenosis causes chest pain or tightness, fatigue, dizziness, shortness of breath and heart palpitations. The result of calcium deposits in the heart valve that cause it to narrow and stiffen, aortic stenosis makes it hard for the heart to pump blood to the rest of the body. Patients with aortic stenosis and symptoms who do not undergo aortic valve replacement face up to a 50 percent mortality rate at three years from symptom onset. Thus, aortic valve replacement is truly a life-saving procedure.
Wendy A. Marano