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Monday, October 15, 2012 - VCU Pauley Heart Center offers nonsurgical aortic valve replacement
Furthering its status as the most comprehensive cardiac care provider in the state, the VCU Pauley Heart Center offers a cutting-edge treatment for a condition that, until now, has required open-heart surgery to address.

Severe aortic stenosis stems from the deterioration and calcification of the heart’s aortic valve, which regulates blood flow from the heart. Patients often experience multiple symptoms — such as fatigue, chest pain, shortness of breath, fainting and dizziness — due to the valve’s inability to fully deliver oxygen-rich blood to the body. Left untreated, this condition carries a 50 percent chance of death within two years, and, unfortunately, many patients traditionally have been left to carry on with only temporary stop-gap treatments or marginal medicinal relief.

Aortic stenosis tends to impact older populations, so risk factors such as age, history of heart disease, frailty and other conditions preclude more than 15 percent of symptomatic patients from being eligible for open-heart surgery. However, through the Pauley Heart Center, those patients now have access to a minimally invasive treatment that, according to Dr. Derek Brinster, director of thoracic aortic surgery and associate professor of surgery in the Division of Cardiothoracic Surgery, can almost double their survival rate.

Administered by a team consisting of members from interventional cardiology, cardiac surgery, advanced cardiac imaging, vascular surgery, cardiac anesthesia and many other disciplines, the transcatheter aortic valve replacement (TAVR) procedure uses an image-guided catheter inserted into the femoral artery in the upper thigh to deliver a new valve to the aorta. Doctors then inflate a small balloon to open and compact the malfunctioning valve before anchoring the new valve in place.

“We’ve always had our eye on care that is less invasive and that will allow us to treat a larger portion of people who suffer from severe aortic stenosis,” Dr. Brinster said, “and VCU has the depth of care and collaboration that makes offering this procedure possible.”

“There are many people for whom you simply can’t perform surgery,” added Dr. Zachary Gertz, director of structural heart disease and assistant professor of medicine in the Division of Cardiology. “So, while we offer things like valve replacement surgery, heart transplants and ventricular assist devices, we also need to ensure we can reach them in this way, as well — through cutting-edge technology that helps patients live longer and better.”

Approved by the Food and Drug Administration in November 2011, the TAVR procedure, improves quality of life and heart function as well as open-heart surgery, but without the arduous recovery process. While surgery still remains the gold standard for treatment, patients often have to stay in the hospital for weeks, followed by months of rehabilitation, before they begin to feel like themselves again. But, with the TAVR procedure, patients can usually sit up the next day and go home within a week to start rehabilitation.

Offering this procedure in addition to surgery is only the first step, as Pauley researchers can now work to develop further advances to the technology and delivery process.

“VCU separates itself from the pack through our clinical research,” Dr. Brinster said. “Since this is a new procedure, it’s undergoing rapid evaluations and changes, and we’ll be at the forefront of that streamlining process.”

For more information or to schedule an appointment, call (804) 828-VALV (8258).

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