Minimally Invasive Heart Valve Procedures Lifesaving for Older and Sicker Patients
Author: Sherry Farney
Advances in the field of cardiovascular care, including heart valve replacement and repair, benefit patients every single day. Some have additional meaning when they can help patients live more comfortable and longer lives. Most often when a patient cannot tolerate surgery it’s due to a combination of their age and overall health. Enduring more than one open heart surgery is often not the best option. Fortunately, there are minimally invasive options for patients who have diseased aortic or mitral valves in need of repair or replacement.
One common valve disease that can require a valve replacement is aortic stenosis. This disease state is the narrowing of the heart’s main valve which pushes blood out to the body. It typically begins to cause symptoms, including shortness of breath, fatigue and an irregular heartbeat beginning at age 60. The valve opening goes from the size of a fifty-cent piece to that of a dime or smaller. Thus, making it very difficult for the heart to pump blood to the body.
Transcatheter Aortic Valve Replacement (TAVR) is an FDA-approved, minimally invasive procedure for patients considered high-risk for open-heart valve-replacement surgery. The procedure is usually performed through a small puncture in the groin. The heart team inserts a tissue valve into the larger artery there, and using X-ray views, eases it up to the heart, then pushes the damaged valve aside and implants the new one. At McLaren Flint, the procedure is performed in the hospital’s state-of-the-art hybrid operating room. For patients, the combination of the physician expertise and technology means improving the quality and duration of their lives.
“Without TAVR the average life expectancy for these patients with severe symptomatic aortic stenosis is only one to two years,” said Sanjay Batra, MD, board-certified cardiothoracic surgeon and director of surgical structural heart at McLaren Flint. “This is a low risk option for patients aged 70 and above.”
Even patients in their 90s can be considered for this procedure.
“For several years TAVR was an FDA-approved, minimally invasive procedure for patients only considered high-risk for open-heart valve-replacement surgery,” said Ahmad Munir, MD, board-certified interventional cardiologist and medical director of structural heart at McLaren Flint. “The CMS approval in 2019 for low-risk patients who have no other major health issues was wonderful news for so many more people who can benefit from the procedure.”
The second of the four main valves in the heart that may need replacement or repair is the mitral valve, which lets blood flow through the heart during half of the heartbeat. Over time this valve can prolapse, or droop, letting blood constantly leak between the chambers. In the most serious cases it can cause abnormal heartbeats that can become life-threatening causing heart failure or stroke.
The structural heart team at McLaren Flint performed the region’s first transcatheter mitral valve replacement (TMVR) more than a year ago. This procedure is for patients who have previously had an open-heart surgical procedure in which their mitral valve was replaced. Should their replacement valve become diseased again, or quit functioning properly, they likely will not qualify for a second open-heart procedure. Now, TMVR is an available treatment option that can also improve the quality and duration of patients’ lives.
To learn more about the heart valve clinic and structural heart procedures performed at McLaren Flint, visit mclaren.org/flintheart.