Cardiothoracic Surgeon Explains TAVR

Hearing a physician say you have an aortic valve that needs replacing is a frightening moment. Most people would envision a major operation, followed by a lengthy recovery period. Like many areas in health care, technology has changed and improved patient care.

There is now a minimally invasive procedure called transcatheter aortic valve replacement (TAVR). For most valve replacement patients, open-heart surgery, including the heart-lung machine, is no longer needed. Ramin Beygui, MD, Medical Director of the Washington Hospital/UCSF Cardiac Services program at Washington Hospital said, “TAVR is very important because it expands our ability to provide a minimally invasive treatment to those who in the past would be at significant risk in open heart surgery.”

The relatively new, minimally invasive valve replacement procedure usually requires no more than a one or two-day stay in the Hospital. Patients often return to normal activities within a few days.

Dr. Beygui will talk about this cutting-edge, minimally invasive procedure during an online Health & Wellness seminar, “TAVR: Minimally Invasive Procedure for Heart Valve Replacement” on Feb. 8 at 2 p.m. The free seminar will take place on Facebook and YouTube. For more information or to register, visit whhs.com/events or call 800.963.7070.

After consulting with a cardiothoracic surgeon, a TAVR procedure can be considered for all patients suffering from severe aortic stenosis. Dr. Beygui noted that outcomes for TAVR procedures are equal or superior to traditional open-heart surgery for aortic valve replacement. “Data shows younger patients are candidates for TAVR,” Dr. Beygui said. “We have done the procedure for patients younger than 75, which was the average age in the early stages. I have had patients younger than 60 and older than 90. The oldest was 101.”

The aortic valve is critical because it allows blood to flow through the heart. As a minimally invasive procedure, TAVR allows the replacement of a diseased aortic valve without opening the chest. “We insert a tiny catheter into an artery in the groin,” he explained. “A fully collapsible replacement valve is delivered through the catheter to the valve site. Once the new valve is expanded, the replacement valve takes over.”

Dr. Beygui pointed out that medication is not an effective method to treat severe aortic stenosis. This condition represents a clear danger and requires surgery. “Aortic stenosis is a mechanical problem. The role of a valve is to allow the blood to travel without a leak and if it cannot, this needs to be corrected surgically.”

The initial TAVR trials began in 2008 and came into general use in the United States in 2011. Dr. Beygui has performed TAVR surgery since 2016. The affiliation between Washington Hospital and UCSF results in patients receiving academic-level care without leaving the area. It is part of Washington Hospital’s goal of bringing doctors to patients, rather than the other way around.

During the upcoming seminar, Dr. Beygui will discuss the early warning signs that could be associated with heart valve conditions requiring attention and why minimally invasive TAVR may be the correct option.

“I will review possible indications, signals and symptoms of aortic stenosis, why it happens, what to expect for the recovery time and what the follow-up period after the procedure looks like,” he said. TAVR patients are monitored overnight after the procedure and can go home the next day. The follow-up routine is just to make sure everything has gone well.

To view the Feb. 8 seminar on Facebook, sign in to your account and then go to facebook.com/WashingtonHosp. Watching from YouTube does not require an account. Simply go to YouTube.com/whhsInHealth. Following the live event, this seminar and hundreds of other Washington Hospital productions will be available at YouTube.com/whhsInHealth.

To learn more about TAVR and other cardiovascular procedures performed at Washington Hospital, visit whhs.com/heart.