Center for Aortic Valve Disease

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Aortic valve disease can decrease quality of life and lead to serious complications, including heart failure.

At the UPMC Center for Aortic Valve Disease, our experts specialize in the latest treatment options, including minimally invasive catheter-based techniques, and provide individualized treatment plans for each patient.‚Äč

About the Center for Transcatheter Aortic Valve Therapy

Your heart has four valves and four chambers that open and close to keep blood flowing in the right direction. The aortic valve connects your heart’s lower left chamber—the left ventricle—to the body’s largest artery, the aorta. In most cases, the aortic valve has three flaps called leaflets which open fully and close to allow for healthy blood flow.

When the aortic valve becomes stiff or narrow, blood cannot flow properly. This can lead to a range of symptoms, decreased quality of life, and over time, a serious condition known as heart failure, when the heart cannot pump effectively.

How we can help

At the UPMC Center for Transcatheter Valve Therapy, we offer patients access to a team of experts who can help diagnose and treat aortic stenosis. We also:

  • Have expertise in the most current types of valves designed for a wide range of risk for surgery.
  • Work together with the patient and family to determine the best course of treatment after a complete evaluation of medical history, co-morbidities, and disease symptoms.

Our goals at the Center for Transcatheter Aortic Valve Therapy

Our main goals at the Center are to:

  • Improve outcomes for patients with severe aortic stenosis by providing the most appropriate treatment plan for their disease.
  • Participate in the latest research studies of devices and treatments to offer the latest treatment options for patients.
  • Educate patients and their families about treatment options in the face of an aortic valve disease diagnosis.

Signs and Symptoms of Aortic Valve Disease

Aortic valve disease may not have symptoms at first, but may include:

  • Shortness of breath
  • Chest pain or tightness
  • Dizziness
  • Fainting, especially after exercise or with exertion
  • Leg swelling
  • Fatigue

Types of Aortic Valve Disease

Aortic valve disease can be present from birth or develop as you age. Our multidisciplinary team of experts provides treatment for all types of aortic valve disease, including:

  • Aortic stenosis
  • Aortic regurgitation
  • Bicuspid aortic valve
  • Rheumatic valve disease

Treatment of Aortic Valve Disease

To develop your treatment plan, our multidisciplinary team takes your individual condition, medical history, symptoms, and quality of life into consideration. We provide the latest treatment options for all stages of aortic valve disease, including:

  • Medical management for heart failure symptoms
  • Minimally invasive surgery
  • Transcatheter aortic valve replacement
  • Open heart surgery

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About the TAVR Program

TAVR offers a minimally invasive valve replacement option for people with severe aortic stenosis and for patients with failing previous surgical tissue aortic valve replacements.

Severe aortic stenosis is a condition in which the aortic valve does not fully open, decreasing blood flow from the heart to the body.

Many people with severe aortic stenosis develop debilitating symptoms that can restrict normal daily activities.

For many years, treatment options for severe heart valve conditions were limited to open heart surgery and medical therapy.

Now, TAVR offers a less invasive approach for people who are at increased surgical risk or have been turned down for traditional aortic valve replacement because of age or other medical conditions.

What to Expect with Transcatheter Aortic Valve Replacement (TAVR)

When referred to the TAVR program at the Transcatheter Aortic Valve Therapies Center, you will have a thorough evaluation by a multidisciplinary team of UPMC heart valve specialists. If you are a candidate for TAVR, you may expect:

  • No need to open the chest to perform open heart surgery
  • Smaller incision or no incision at all
  • Less anesthesia using sedation and shorter time in operating room
  • Shorter length of stay in the hospital and faster recovery time

Your TAVR Journey

Exams and Tests Before TAVR

During your TAVR evaluation, you’ll meet with our multidisciplinary heart valve team that includes a cardiac surgeon, interventional cardiologist, and advanced practice providers.

Testing for TAVR evaluation before, during or after the visit may include:

  • Echocardiogram
  • Cardiac catheterization
  • CT angiography (CT scan)
  • 5 meter gait speed
  • Electrocardiogram (EKG)
  • Pulmonary function tests (PFTs)
  • Carotid ultrasound
  • Bloodwork and urine test to evaluate for infection prior to valve replacement.

View or print a TAVR testing checklist with more information.

On the day of your TAVR

  • Arrive at the hospital about two hours before the procedure
  • Meet with the valve team and cardiac anesthesiologist
  • May repeat electrocardiogram and bloodwork
  • Plan on spending around one hour in the operating room and one to two hours in the recovery room before going to a telemetry unit for cardiac monitoring overnight.

What happens during TAVR?

During a TAVR procedure, your doctor:

  • Accesses an artery in your groin or side of your chest.
  • Uses special moving x-ray imaging — called fluoroscopy — and guides a tissue valve with a metal frame on a catheter into the aortic valve.
  • Opens the new valve, using the catheter-based approach, within the old valve. The new valve expands within your existing valve, restoring proper blood flow.

Recovery and care after your TAVR

  • Repeat echocardiogram the day after TAVR.
  • Most patients spend one or two nights in the hospital.
  • Plan on needing help at home from a family member or caregiver for the first week after TAVR.
  • You may need additional outpatient bloodwork after TAVR.
  • The valve team will call you within a week of TAVR to check on you and make sure you are taking your medications as prescribed.
  • You will be seen in the valve clinic one month or sooner after TAVR with an echocardiogram the same day.
  • One year after TAVR you’ll schedule another visit with an echocardiogram.

What are the benefits of TAVR?

Since many people with severe aortic stenosis are at increased surgical risk and have considerable mortality in the short term, TAVR may provide a treatment pathway that would otherwise be unavailable. However, TAVR may not be appropriate for all risk categories.

TAVR:

  • Is a less invasive procedure that surgeons perform while the heart beats.
  • Does not involve open-heart surgery or require the need for a heart-lung bypass machine.
  • May result in a faster, milder recovery.

What are the risks of TAVR?

TAVR is a surgical procedure that involves anesthesia.

Placement of the valve may have serious adverse effects, including risks of:

  • Stroke
  • Damage to the artery used for insertion of the valve
  • Major bleeding
  • Other serious life-threatening events or even death

Our Experience

UPMC was one of the first hospitals in the United States to treat people with severe aortic stenosis with the FDA-approved Edwards SAPIEN Transcatheter Heart Valve and the Medtronic CoreValve®.

We are also enrolling low risk patients in the Medtronic TAVR in Low Risk Patients clinical trials, in addition to the ongoing aortic valve clinical trials available to patients at the UPMC Heart and Vascular Institute.

Our physicians have published numerous articles in leading journals related to transcatheter aortic valve replacement and outcomes.

Tavr 

Above: Edwards SAPIEN Transcatheter Heart Valve

Core Valve 

Above: Medtronic Corevalve
Reproduced with permission of Medtronic, Inc.

Our Aortic Valve Disease Experts

Our multidisciplinary team at the UPMC Center for Transcatheter Aortic Valve Therapy includes experts in cardiology and cardiac surgery.

Advanced Practice Providers

Contact the UPMC Center for Aortic Valve Disease

For patients

To schedule an appointment:

For providers

For information about TAVR eligibility requirements, contact:

  • Lisa Henry, DNP, CRNP, Clinical Project Director, at 412-647-4745 or 1-877-412-VALV (8258)
  • Email ValveCenter@UPMC.edu

For TAVR scheduling

Please call 412-647-1621

We also have satellite sites for evaluation in Monroeville and at UPMC Jameson, UPMC Passavant, UPMC St. Margaret, and UPMC South Hills.