Dr. Chauncey W. Crandall, author of Dr. Crandall’s Heart Health Report newsletter, is chief of the Cardiac Transplant Program at the world-renowned Palm Beach Cardiovascular Clinic in Palm Beach Gardens, Fla. He practices interventional, vascular, and transplant cardiology. Dr. Crandall received his post-graduate training at Yale University School of Medicine, where he also completed three years of research in the Cardiovascular Surgery Division. Dr. Crandall regularly lectures nationally and internationally on preventive cardiology, cardiology healthcare of the elderly, healing, interventional cardiology, and heart transplants. Known as the “Christian physician,” Dr. Crandall has been heralded for his values and message of hope to all his heart patients.

Tags: stenosis | valves | TAVR | heart surgery

Replacing Heart Valves Without Surgery

Friday, 13 April 2018 04:15 PM Current | Bio | Archive

Heart valve problems tend to develop as people age. Aortic stenosis, for instance, is usually diagnosed in men over the age of 65, and women 10 years later in life.

These are hardly the ideal target groups for open-heart surgery.

Fortunately, over the past few years, minimally invasive techniques for valve replacement have been developed — and they do not require drastic measures such as open-heart surgery.

Transcatheter aortic valve replacement (TAVR) is available for either aortic stenosis or mitral valve regurgitation.

The beauty of this new, innovative procedure is that it can be performed from outside the body, and therefore is ideal for older people who are more likely to develop valve problems.

In addition to being less risky, recuperation time is also reduced.

TAVR for aortic stenosis won FDA approval in 2011. For this procedure, the doctor inserts a balloon-tipped catheter into a blood vessel in the the tip of the balloon is a new, folded-up valve.

Once the catheter is in place, the new valve is deployed, pushing the old one out of the way and replacing it.

The FDA originally approved TAVR only for patients with severe, inoperable stenosis, but this category was later expanded to include those who were at high risk, but operable.

To comply with this restriction, there is a strict application procedure — TAVR is reserved for patients who would have a 15 percent chance of dying if they were to undergo open-heart surgery.

For mitral regurgitation, a device called a “MitraClip” is delivered through a similar catheter system. This device attaches to the valve’s leaflets and pinches them together, creating an opening that reduces leakage.

TAVR has been in use longer, so there is more of a research record. Originally, it was thought the procedure would increase stroke risk, but that has not been the case thus far.

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Over the past few years, minimally invasive techniques for valve replacement have been developed — and they do not require drastic measures such as open-heart surgery.
stenosis, valves, TAVR, heart surgery
Friday, 13 April 2018 04:15 PM
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