Published February 2, 2012
A team of UB and Buffalo General Hospital physicians was among
the first in the country to perform transcatheter aortic valve
replacement (TAVR), a minimally invasive alternative to open-heart
surgery.
Led by Vijay
Iyer, MD, PhD, assistant professor of medicine,
they performed the procedure in mid-January on two patients, both
of whom are doing well.
“This procedure provides many patients who have been
deemed inoperable an opportunity to get what is a life-saving
treatment with proven improvements in survival and quality of
life,” Iyer said.
Buffalo General was selected to offer TAVR after the procedure
received FDA approval in November. In New York State, it is the
only facility west of Albany approved to carry it out.
“The implementation of the valve is a complex process that
requires the collaboration of cardiologists, cardiac surgeons,
vascular surgeons, anesthesiologists and radiologists,” Iyer
explained.
During the procedure, surgeons deliver a collapsible bioprosthetic valve through the femoral artery into the heart. Once the artificial valve arrives at the aorta, it is inflated by a balloon and goes to work immediately. The heart continues to beat, eliminating the need for a cardiopulmonary bypass.
TAVR is approved only for patients with severe age-related aortic stenosis who can’t tolerate open-heart surgery. In Western New York, about 70 patients a year are expected to meet the criteria, Iyer said.
All told, aortic stenosis affects some 1.5 million Americans. The condition causes the aortic valve to narrow, forcing the heart to work harder to pump blood to the body.
Patients with severe aortic stenosis often develop debilitating systems, such as extreme shortness of breath and dizziness.
Those deemed inoperable typically fare worse than individuals
with certain metastatic cancers: Studies have shown that more than
half of these patients die within two years of the onset of
symptoms.
The bioprosthetic valves used during TAVR represent the
collaboration of biomedical engineers and clinicians as well as
years of engineering design improvements and delivery techniques,
noted Iyer, whose research interests include investigational
interventional devices.
They demonstrate the kinds of benefits translational medicine offers patients, he added—advances that the UB Clinical and Translational Research Center, under construction on the Buffalo Niagara Medical Campus, will foster.