Emory University Heart and Vascular Center at the Forefront of Transcatheter Aortic Valve Implantation

Aortic stenosis (narrowing of the aortic valve) is the most common valvular heart disease in the Western World that requires surgery. Until recently, the only option for patients with severe symptomatic aortic stenosis was open heart surgery for valve replacement. Since 2002, Transcatheter Aortic Valve Implantation (TAVI) has been studied in Europe as a new technique that overcomes the limitations of open heart surgery by using catheters to implant valves through a small incision. In 2005, this technology reached the United States, and subsequently Emory University Hospital has become a major contributor to the development of this technique for patients with aortic stenosis that are inoperable or high risk for surgery.

The most common reasons patients are high risk for standard surgical aortic valve replacement (SAVR) include advanced pulmonary disease, severe immunosuppressive diseases, a completely calcified (porcelain) aorta, previous chest wall irradiation, multiple previous surgical procedures and multi-system organ dysfunction (most commonly, renal failure). In addition, patients are occasionally turned down for surgery if, in the opinion of the surgeon (often based on consultation with the family), the patient’s overall level of function and degree of de-conditioning makes such an operation very unattractive. It is important to note that no risk score system in current use has managed to accurately capture all of these conditions. However, the evaluation of “non-operable” is often established by the assessment of a cardiologist and a cardiac surgeon.

The TAVI procedure is performed at only 22 centers in the United States as part of an FDA trial known as PARTNER (Placement of AoRTic TraNscathetER Valve Trial).  Emory University Hospital was one of the top 5 enrollers in the North American PARTNER trial which completed enrollment in September 2009.  Currently, investigators at Emory are planning to start the PARTNER II trial in the summer of 2010, which will study the TAVI procedure using the latest Edwards SapienTM Heart Valve (Edwards Lifesciences, Irvine, California). More information regarding TAVI and the PARTNER trial can be found at www.edwards.com.  If you would like to be evaluated for TAVI at Emory Hospital, please call 404-712-7667.

The TAVI procedure is one of many techniques unique to the Emory Structural Heart Disease Center. Other procedures include minimally invasive surgical or catheter based techniques to treat mitral valve disease, pulmonary valve disease, hypertrophic cardiomyopathy, atrial septal defects, patent foramen ovale, and other congenital or post cardiac surgical heart defects. For more information regarding the Emory Structural Heart Disease Center, please email eblock@emory.edu .