A Less Invasive Alternative for Aortic Stenosis

As our population ages, more patients with severe aortic stenosis are deemed not suitable or at high risk for open heart surgery.  The standard therapy for this condition, in which the aortic valve narrows – reducing the amount of blood that flows through it – is limited.  But now there is another option.

Cleveland Clinic helped lead the research for a game changer in heart care: transcather aortic valve implantation (TAVI).  This now proven minimally invasive alternative to open heart surgery involves transporting a synthetic valve to the heart through a small incision in the groin or chest.

"For many years, we have been exploring ways to solve this problem of life-limiting aortic stenosis in high-risk populations,” says interventional cardiologist Murat Tuzcu, MD, Vice-Chairman of the Cardiovascular Medicine Department at the Miller Family Heart & Vascular Institute at Cleveland Clinic.  "TAVI is a very exciting way of helping these people."

Cleveland Clinic has been one of the foremost leaders of this technology in the United States since the beginning, notes Dr. Tuzcu, who with co-investigators Lars Svensson, MD, (cardiac surgery) and Samir Kapadia, MD (interventional cardiology).

In the United States, TAVI is still an investigational device.  It was implanted during a clinical trial called the Placement of Aortic Transcatheter Valves (PARTNER) trial.  Though the study is now closed, Cleveland Clinic continues to use the technology in patients under the U.S. Food & Drug Administration’s Continued Access Clause, which allows inoperable aortic stenosis sufferers to be considered as candidates for this cutting-edge solution.

The PARTNER trial results, which were released in September 2010, support TAVI as a solution for otherwise inoperable aortic stenosis patients.  The study found those deemed inoperable who received TAVI compared to standard therapy had an absolute reduction in mortality of 20 percent.  That translates to saving one life in every five patients who were treated with TAVI.  Those who received traditional therapy had a mortality rate of 50 percent.

In the near future, the results of its use in patients who were at very-high, but not prohibitively-high, risk for standard open heart surgery will be released.  TAVI is already widely used in high-risk cardiac patients in Europe and use of the device is starting to expand to lesser-risk patients.  To find out if you are a candidate for TAVI, call 800.659.7822