A UVA Heart & Vascular Center Initiative

Minimally Invasive Treatments for Valve Disease on the Rise

Posted August 09, 2016

While birth defects, infections or conditions such as heart disease may cause heart valve problems, the most common cause today is aging. “Every moment, our heart is beating and that causes wear and tear on the heart,” explains Scott Lim, MD, medical director of the UVA Advanced Cardiac Valve Center. “For most of us, that’s just fine. But with the aging of the population, as people get into their 70s, 80s and 90s, we’re seeing heart valve problems becoming much more common because people are living longer than they used to.”

Fortunately, there are now life-saving procedures to treat valve disease that are less invasive and, thus, a better alternative for those at high risk for traditional open-heart surgery due to advanced age or compromised health. As these new devices and surgical techniques become more widely available, however, it’s important to note that not all centers offering these treatments are created equal.

Recent research has shown that, when it comes to treating heart valve disease, practice makes perfect. At a recent American College of Cardiology Annual Scientific Session, researchers reported that hospitals that perform a high volume of transcatheter aortic valve replacement (TAVR) procedures (using small incisions and catheters to replace a diseased heart valve) have better outcomes.

UVA Advanced Cardiac Valve Center is one of only a few sites in the U.S. offering the full spectrum of treatment options for repairing and replacing all cardiac valves, including surgical, minimally invasive and transcatheter approaches. The UVA team has been performing TAVR since it was first introduced in 2009, as one of 26 U.S. sites selected to participate in a trial for the initial TAVR device. Since that time, UVA has completed nearly 400 TAVR procedures. That’s significantly above the national average.

“We were truly at the forefront of this treatment,” says Gorav Ailawadi, MD, surgical director of the UVA Advanced Cardiac Valve Center. “Since that first study, we have been involved in more than four additional clinical trials for the newest TAVR devices.”

When Surgery Is the Best Option
Not all patients with valve disease qualify for minimally invasive procedures like TAVR. At UVA, these patients have access to the full range of surgical treatments as well, including minimally invasive and standard approaches, performed by leading specialists in the field. In 2015, UVA was one of only 27 hospitals to achieve the highest, three-star rating for aortic valve replacement (AVR) from the Society of Thoracic Surgeons.

“Just as it’s been shown that high-volume centers have better outcomes with TAVR, the same is true of surgical valve repair and replacement,” says Ailawadi. “We not only do a high volume of cases, we do those that are more complex and may not be not done elsewhere. We have become a destination for many patients as well as other physicians learning to do these procedures.”

Clinical Trials Provide Greater Options
UVA has a long history of participation in valve studies and continues to push for safer approaches and ways to bring the latest technology to more patients. As one of eight accredited core members of the Cardiothoracic Surgical Trials Network (CTSN), sponsored by the National Institutes of Health/National Heart Lung and Blood Institute, UVA researchers are involved in high-profile clinical trials that directly impact the way we treat cardiovascular disease nationwide.

“Because of our involvement in clinical trials, we provide our patients with access to the next generation of valve technology and we’re able to offer valve replacement to more patients with aortic valve disease,” says Lim. “Other centers in our region are limited to treating only those who are high risk or inoperable,” says Lim.

If you have heart valve disease, talk to your doctor about treatments currently available at UVA.