FLORENCE, S.C. -- Transcatheter aortic valve replacement (TAVR) is a less-invasive surgical procedure used to treat aortic valve disease rather than the traditional method – surgical aortic valve replacement or SAVR – and is being performed at McLeod Regional Medical Center.
This procedure allows doctors to replace the valve without removing the old, diseased valve and is performed without open-heart surgery. The replacement valve is positioned inside the native aortic valve that has narrowed and doesn’t open and close properly. The narrowing of the valve is called Aortic stenosis, limiting the blood flow leaving the heart.
“It has been revolutionary,” said Dr. Scot C. Schultz of the McLeod Heart and Vascular Institute. He said that in his 21-plus years as a heart surgeon, it is by far the biggest advancement in his field of medicine.
“It is one of the most satisfying procedures I do,” he said. “In heart surgery, things don’t happen quickly, because the stakes are very high. We wouldn’t want to put a valve in that wasn’t going to last you a very long time.”
Although McLeod has been working toward using this procedure for several years the first one was performed in February 2017 by Drs. Fred Krainin, Brian Wall and Schultz. Over the past two years, they have replaced close to 100 valves with this revolutionary minimally invasive technique.
While this less-invasive procedure was originally approved for the inoperable or extreme-risk patients, it is now being offered to those who are less at risk.
Valve disease is primarily a disease of the elderly, and many can’t withstand the stress of an open-heart procedure, Schultz said.
Schultz said most of his patients are in their 70s and 80s. The oldest person his team has performed the procedure on was in the 90s, and for someone of that age, he said, the conventional surgery would be monumental.
With TAVR, the physician inserts a catheter, a long flexible thin tube with the artificial valve, made of pig or cow tissue, through a small incision in an artery, usually in the leg, then guides it to the heart. The valve is positioned across the diseased valve. The new valve is expanded and starts working immediately. Schultz said they have a very good relationship with the vascular surgeons at McLeod who have assisted them on the difficult patients to minimize complications.
Another plus for TAVR is that it requires the patient to be in the hospital only a couple of days, while SAVR patients are in the hospital for about a week with two to three months of recovery time, Schultz said. He said there is little or no pain involved, and blood thinners are usually not required.
The McLeod Valve team is approaching its 100th TAVR procedure. The valve team includes cardiothoracic surgeons Schultz and Dr. Cary Huber; interventional cardiologists Dr. Fred Krainin and Dr. Brian Wall; anesthesiologists Dr. Daniel Fox, Dr. Kyle Johnson and Dr. Robert Savage; and nurse practitioner and McLeod Valve Clinic coordinator Ryan Hill.