Offering ground-breaking technology and unmatched expertise, the Cooper Heart Valve Center has rapidly become the top site in the state, and one of the top five commercial sites in the nation for the performance of transcatheter aortic valve replacement, TAVR.
TAVR, the revolutionary percutaneous aortic valve, received FDA approval in late 2011 for use in patients unable to undergo surgical aortic valve repair. Cooper University Hospital was one of the first sites in the nation to offer the innovative therapy after approval.
“Cooper has assembled a multi-disciplinary team that is a model for sites across the nation,” says Zoltan G. Turi, MD, Director of the Cooper TAVR and Structural Heart Disease Programs. “Our team includes surgeons, interventional cardiologists, echocardiographers, a radiologist, cardiac anesthesiologists, and physician assistants, who work together at many stages of the process, including a joint meeting on the days we perform TAVRs to review the cases in detail.”
The Cooper Heart Institute also welcomes the recent expansion of TAVR indications. The FDA recently extended TAVR approval to include patients at high risk for surgery. Previously TAVR was approved for inoperable patients only. This broadening of indications will significantly expand the reach of the TAVR program, opening the option of percutaneous aortic valve replacement to many more patients than the current guidelines allow.
Completion of the new Cooper hybrid cardiac catheterization suite will allow the growing TAVR program to move to the catheterization laboratory from its current location in the operating suites. The technological upgrades will make available 3-D echo and cardiopulmonary bypass along with open heart capabilities in the catheterization suite.
“The FDA is reportedly adding additional therapeutic approaches in late 2012”, says Frank W. Bowen, III, MD, cardiothoracic surgeon for the Cooper TAVR program. “They are likely to introduce the option of a transapical approach for TAVR candidates. This approach allows patients with smaller arteries to have a mini-thoracotomy to have the device placed across the aortic valve via the apex of the beating heart.”
TAVR is only one of the structural heart disease repair opportunities the Cooper Heart Institute’s Heart Valve Center has planned for 2013. The hybrid room capabilities will allow Cooper to offer both a novel technology for left atrial appendage occlusion as an option to anti- coagulant therapy in atrial fibrillation, as well as a new percutaneous mitral valve repair technique.
New Treatment Option for A- Fib Patients
The Cooper Heart Institute is the first site in the region to offer an innovative catheter- based atrial appendage occlusion treatment option for patients with atrial fibrillation who are unable or unwilling to be anticoagulated. Unlike earlier procedures (also pioneered at Cooper) that were designed for patients who were able to take anticoagulants, the LARIAT ™ device is FDA approved for all patients with atrial fibrillation, whether or not they can be anticoagulated.
The procedure involves placing a suture around the neck of the left atrial appendage, obliterating this major site of thrombus formation. Similar to a pericardial drainage procedure, the LARIAT ™ is advanced over a magnetic tip guidewire that allows a lasso to be placed over the atrial appendage and prevent clot formation. Unlike prior technologies, the LARIAT ™ leaves no device inside the heart at all.
Cooper University Hospital remains a Delaware Valley leader in all heart valve repair and replacement. Ranked in the top 6 percent of aortic valve repair programs nationwide by the Society of Thoracic Surgery (STS), Cooper cardiac surgeons perform 95 percent of aortic valve replacement surgeries, and two-thirds of mitral valve procedures minimally invasively. Cooper also maintains exceptional outcome statistics for the surgical mitral valve repair program, reporting no mortality for mitral valve repairs in 2009, 2010, and 2011. The Cooper Heart Valve Center is a regional center of excellence for valve disease care providing comprehensive assessment and management for aortic, mitral, pulmonic and tricuspid disease.
For more information about TAVR, the Cooper Heart Valve Center, or to refer a patient for heart valve consultation, please call 856.296.6516.