From an interview with
Dr. William C. Jackson
McLeod Vascular Associates Florence
In the past, many people with faulty aortic heart valves could not receive a new heart valve without opening their chest for surgery. Now, McLeod Vascular Surgeon Dr. William C. Jackson says refinement of an existing technique eliminates the need for opening the chest to replace a heart valve.
Here’s a summary of Dr. Jackson’s comments:
Aortic stenosis is a narrowing of the aortic valve. That’s one of the four valves in the heart. And it is responsible for ejection of blood from the heart into arterial circulation — into the brain, the abdomen and the legs. And if that valve becomes too narrow, patients have significant symptoms, including shortness of breath and chest pain. They can’t do the things they want to do. They can’t walk around a store or undergo their daily activities. They may warrant treatment for that aortic stenosis. If stenosis isn’t responsive to medical therapy, the patient would need a valve treatment. People with congestive heart failure from aortic stenosis certainly need treatment.
Transarterial Valve Replacement (TAVR) takes patients that were previously not candidates for valve replacement through the open surgical approach (opening the chest, called sternotomy) and provides them a treatment option for their aortic stenosis. TAVR enables us to improve a quality of life in patients, who previously simply had no options for therapy. It is an important role in our treatment of valve disease and, generally, has a shorter hospital stay, lower operative risk, and gives patients a durable, similar result.
The Vascular Surgeon’s role varies from patient to patient. However, a patient may have disease in the groin artery, and we cannot gain access to the heart valve. The vascular surgeon would make an incision, expose the artery, potentially repair it or fix it, sometimes insert stents to keep it open, or even sew a bypass that allows us to get past that blockage to fix the valve. Then, after the TAVR procedure, the Vascular Surgeon repairs the rest of the artery and gives the patient good blood flow back to their leg.
In the appropriately selected patient, we may make an incision in the neck, go in through the neck artery and deploy the valve. We also may choose to go in through the arm artery or the artery in the chest and deploy the valve in this manner. Patients who previously were told, “I’m sorry, there’s nothing we can do,” now have an option.
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