Transcatheter Aortic Valve Replacement or (TAVR) is a revolutionary new treatment option for patients with severe aortic stenosis who are not well enough to undergo traditional open heart surgery. HackensackUMC is the first program in Northern New Jersey to provide the TAVR procedure, and remains the only fully approved program in Northern New Jersey, Orange, Rockland, Hudson and Westchester counties.
Patients who suffer from aortic stenosis- a progressive disease that affects the aortic valve of the heart- often experience symptoms that can restrict normal day-to-day activities, such as walking short distances or climbing stairs. Severe aortic stenosis is a serious problem. Patients who do not receive an aortic valve replacement (AVR) have no effective, long-term treatment option to prevent or delay their disease progression. Without it, severe aortic stenosis is life threatening – studies indicate that 50 percent of patients will not survive more than an average of two years after the onset of symptoms.
Until now, the only treatment for severe aortic stenosis has been open aortic valve replacement, but if a cardiac surgeon determines that you are not a candidate for open-heart surgery and if medicine is not helping you feel better, the TAVR procedure may be an alternative. TAVR is approved for patients who have shortness of breath or chest pain from a severely narrowed aortic valve and who are to sick for an open aortic valve operation.
The transcatheter aortic valve procedure is a minimally invasive surgery which requires only a 3-4 inch incision in the leg or left chest wall. This procedure enables the placement of a balloon-expandable heart valve into the body with a tube-based delivery system (catheter). The valve is designed to replace a patient’s diseased native aortic valve without traditional open-chest surgery and while the heart continues to beat – avoiding the need to stop the patient’s heart and connect them to a heart-lung machine which temporarily takes over the function of the heart and the patient’s breathing during surgery (cardiopulmonary bypass). Most patients will leave the hospital within 4-6 days and can resume all normal activities within 10 days of the procedure.
Our Heart Team
At HackensackUMC, we take pride in our ability to successfully help patients with highly complex cases and maintain an exceptional success rate. The Heart Team physicians bring over 70 years of experience to each patients case.
Dr. Jock McCullough
Dr. Elie Elmann
Dr. Thomas Cocke
Dr. Pranay Vaidya
To find out more, please call 551-996-5388
What is TAVR?
TAVR stands for Trans-Catheter Aortic Valve Replacement. TAVR is a minimally invasive procedure performed without the need for a heart and lung machine under general anesthesia. A small (3-5 inch) incision (opening) is created in the upper leg through which the new aortic valve is placed.
How do I know if I am a candidate? I have been told that I need an Aortic Valve Replacement. Can I have a TAVR procedure instead?
TAVR is performed only on patients that have been classified as very high risk and or inoperable. Your cardiologist will be the first one to tell you whether you might be a candidate for the Trans-catheter Aortic Valve Replacement. The Heart and Vascular Institute at Hackensack University Medical Center TAVR team will then conduct a comprehensive evaluation to determine whether this procedure is an appropriate option for you.
How do I get evaluated?
When a diagnosis of severe aortic valve stenosis is confirmed by your cardiologist and they feel that you might benefit from the TAVR procedure you can contact the TAVR coordinator Mrs. Elle Delaportas at 201-996-5388. Mrs. Delaportas will assist you in gathering your records, reports of studies already done along with their films. Once we have received and reviewed the patient information you will then meet with the TAVR team. Some patients have multiple risk factors and challenges that may need to be managed or worked up first. Some of these diseases can greatly affect the recovery period, this is why we are devoted to our patients and give our undivided attention to offer you the safest and the best surgical approach for you. We will be working closely with your other physicians with on-going communication to ensure continuity of care and that you receive the most suitable treatment throughout this whole process.
How experienced is the TAVR Team?
The TAVR multidisciplinary team consists of 4 highly qualified physicians. Two cardiac surgeons who have performed hundreds of aortic valve operations and 2 Interventional Cardiologist who perform structural heart catheterizations and diagnostic testing for cardiac and valve procedures. A specially trained cardiac anesthesiologist and a TAVR coordinator, whose role and responsibilities are to ensure continuity of patient care throughout the entire process providing direct communication with referring physicians. Hackensack University Medical Center was the fist to perform this procedure in northern New Jersey and remains the only program in North Jersey with a significant history of successful TAVR procedures.
Is this procedure covered by insurance and do I need a referral?
TAVR is covered by Medicare and almost all commercial insurance companies. All the heart team physicians participate in Medicare and accept most major insurance. Most insurance companies do not require a referral, but contact you insurance carrier prior to your appointment.
How long is the procedure and how long will I be in the hospital?
The transcatheter aortic valve replacement (TAVR) procedure takes about 3-4 hours to complete. You will be under general anesthesia for the entire procedure and when you wake up you will be in our Cardiac Surgical Intensive Care Unit. The nurses will quickly get you out of bed and physical therapy will be started. You will be in the ICU until our team feels you can be transferred, usually within 24 hours. When you are cleared to be transferred to our Cardiac Surgical Step Down you will continue to have physical and occupational therapy. Our average length of stay is 4-5 days being monitored on a daily bases. Patients and family members meet with a social worker and a case manager to begin discussing discharge plans and which option would be safe for you.
How big are the incisions?
Once all the testing has been completed, the multidisciplinary TAVR team determines which access site will be the safest pass for the catheters and the new valve. You will have a small, 3 -5 inch incision in your upper leg or on the left side of your chest.
What limitations are there after surgery?
Immediately on day of procedure the staff will get you out of bed and working with you. You will be encouraged to walk around as often as you can and you will be supervised throughout your hospitalization. There will be a physical therapist working with you to prepare you for when you are discharged. We will provide you with specific instructions to help you with your recovery, which includes a special diet, bathing, exercising, and medicine.
To learn more about the TAVR procedure, please visit : EDWARDS Sapien Valve http://www.edwards.com/Products/TranscatheterValve/Pages/THVcategory.aspx