Think of the heart as the body’s engine, with multiple parts working together to regulate blood flow. One of these essential parts is the aortic valve, which is located between the left ventricle and the aorta.
The aortic valve operates like a gate. Typically, this valve has three leaflets (also called cusps) that open and close, which allows blood to push through the valve and be distributed throughout the body. When this process doesn’t happen properly, it’s referred to as aortic valve disease.
Traditionally, open heart surgery and medication were the only ways to treat aortic valve disease. For patients in western Pennsylvania, that changed in 2011 when UPMC became the first health care provider in the region to offer transcatheter aortic valve replacement (TAVR). Because of UPMC’s extensive clinical experience and strong outcomes over the past decade, the UPMC Heart and Vascular Institute is one of few institutions in the region to have performed more than 2,000 TAVR procedures.
Different Types of Aortic Valve Disease
The most common form of aortic valve disease is aortic stenosis. This condition is characterized as a narrowing or a tightening of the aortic valve, causing the heart to work harder to distribute blood throughout the body. Over time, this could weaken the heart and lead to congestive heart failure.
Aortic regurgitation is the opposite problem – rather than closing too tightly, the aortic valve doesn’t close tightly enough, and the blood can leak backward toward the heart. Aortic regurgitation is less common than aortic stenosis but also can be detrimental to your health.
Another type of aortic valve disease is bicuspid aortic valve. As mentioned, the aortic valve normally has three leaflets, but a person with a bicuspid aortic valve is born with just two leaflets. This common condition affects 1% to 2% of the general population. This condition also can cause the aortic valve to narrow or tighten or to be leaky.
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Common Risk Factors for Aortic Valve Disease
While anybody can be diagnosed with aortic valve disease, some common risk factors include:
- Chronic kidney disease or renal failure
- History of infections that can affect the heart
- History of radiation therapy to the chest
- Heart conditions present at birth (congenital heart disease)
How Does TAVR Work?
TAVR works by replacing the diseased aortic valve with a new one.
- The procedure begins with your doctor making a small incision, usually in the groin, which allows access to the femoral artery.
- Through this artery, your doctor will guide a valve at the end of a long catheter that is gently placed across your diseased native aortic valve in the heart.
- Once there, the new valve is deployed, and displaces and takes over the function of the diseased aortic valve, which will restore proper blood flow to the body.
“And it takes over the function of the diseased valve,” adds Ibrahim Sultan, MD, co-director, UPMC Center for Heart Valve Disease. “The procedure is minimally invasive, allowing patients to recover fast, have a shorter length of stay in the hospital, less pain and less limitations after the procedure.”
After the procedure, you can expect to spend one to two days in the hospital.
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Who Is a Good Candidate for TAVR?
Experts at the UPMC Center for Heart Valve Disease take a 360-degree approach to determining the appropriate care for patients, which means the center is multidisciplinary. Cardiologists, surgeons, anesthesiologists, advanced practice providers, and other experts work together as a team to tailor treatments to each individual patient.
If you have an increased risk of medical complications from open heart surgery or have severe, symptomatic aortic valve disease, a UPMC expert may recommend TAVR for you.
Taking Care of Your Heart Health During the COVID-19 Pandemic
Dr. Sultan and other medical experts agree that it’s to not delay any necessary heart care as the COVID-19 pandemic continues. If left untreated, aortic valve disease can cause:
- Shortness of breath
- Chest pain or tightness
- Congestive heart failure
“While COVID-19 remains at the center of our attention, it is important to remember that heart disease continues to be the leading cause of death for both men and women in the United States,” Dr. Sultan says.
UPMC has taken various precautions to ensure the safety of every patient when receiving care. One such precaution is that many appointments can be conducted via Telemedicine rather than in-person visits. Sometimes your doctor will need to see you in person to ensure you receive the best possible care. Safety measures like universal masking and social distancing remain standard practices at UPMC to keep our patients as safe and healthy as possible.
“These practices can minimize your risk of contracting COVID-19, while ensuring that your heart is well taken care of,” Dr. Sultan says.
Why Choose the UPMC Heart and Vascular Institute?
UPMC was the first health care provider in the region to establish a center dedicated to aortic valve therapies and to perform the TAVR procedure. The UPMC Heart and Vascular Institute has long been a leader in cardiovascular care, with a rich history in clinical research and innovation.
As one of the first heart transplant centers in the country and as the developer of one of the first heart-assist devices, UPMC has contributed to advancing the field of cardiovascular medicine. To learn more about aortic valve disease treatment options or to schedule an appointment, visit our website or call 412-647-1621.
The UPMC Heart and Vascular Institute has long been a leader in cardiovascular care, with a rich history in clinical research and innovation. As one of the first heart transplant centers in the country and as the developer of one of the first heart-assist devices, UPMC has contributed to advancing the field of cardiovascular medicine.