Heart valve procedure TAVR offers new hope, alternative to open heart surgery

Two years ago, doctors told 64-year-old Keith Jones that he would need open heart surgery to fix a faulty heart valve.

Jones was diagnosed with aortic stenosis.

"Aortic stenosis is a thickening; a stiffening and a calcification of the aortic valve. So the valve doesn't open appropriately," Dr. Gregory Giesler, with the Southern California Heart Specialists explains.

Jones said he was told he needed to have a valve replacement.

"It was either going to be open heart surgery, or did I qualify for TAVR?" Jones said.

TAVR or transcatheter aortic valve replacement, is when doctors go through the groin to deploy a new valve and replace the old one. It's traditionally been reserved for elderly patients who are often too frail for open heart surgery.

"The surgery was deemed to be a higher risk than an overall benefit," Giesler said.

TAVR worked very well for those patients, but younger, more fit patients still underwent open heart surgery because researchers weren't sure if TAVR's outcomes would be as good. But results of a new multi-center trial shows they are.

"These people are able to get out of the hospital early. They're able to be active," Giesler said.

At one year, the study authors say patients with TAVR were more likely than surgery patients to be alive without disabling stroke and without hospital admission for heart failure.

"I think it means the future for fixing aortic stenosis is as bright as it's ever been," Giesler said.

For Keith, it was a game changer.

"I had been through open heart surgery before," he said. "I knew what it was like both physically and emotionally."

And he did not want to go through that again.

With TAVR, Keith was home the next day and exercising the next week.

"From somebody who has gone through an open heart procedure and now a TAVR procedure? There is no comparison. It's the best thing since sliced bread," Jones said.

The next step for researchers is to follow low-risk patients for 10 years and then assess the long-term benefits.
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