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TAVR: How Do You Determine the Health of Your Heart Valves
Dr. Sayed Hussian discusses TAVR, and when you might need this procedure.
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Learn more about Sayed Hussain, MD
Sayed Hussain, MD
Sayed Hussain, MD is committed to providing you with professional, quality healthcare using his experience and knowledge. As a member of Florida Cardiology PA since 2010, Dr. Hussain is dedicated to utilizing the latest technological methods for treatment, while simultaneously focusing on prevention of cardiovascular diseases. With a strong background as an internist, his effort is to provide balanced care with a holistic approach.Learn more about Sayed Hussain, MD
Transcription:
Bill Klaproth (Host): Transcatheter aortic valve replacement, or TAVR, is a minimally invasive heart valve replacement procedure that can offer new hope to patients who have aortic valve stenosis and are at a high or extreme risk for open heart surgery. Pretty cool. So let’s learn more with Dr. Sayed Hussain, interventional cardiologist at Osceola Regional Medical Center’s Heart and Vascular Institute. This is Helmet of Health, a podcast from Osceola Regional Medical Center. I'm Bill Klaproth. Dr. Hussain, so tell me. Why do heart valves go bad?
Sayed Hussain, MD (Guest): There are many different varieties of reasons of why cardiac valves can degenerate and be compromised. Some are genetic congenital heart disease related, but many of these other conditions are acquired with the aging process. Conditions such as high blood pressure and other variety of comorbidities that can cause a valve to either become leaky or narrowed.
Host: Okay. So that’s what’s good to remember. When they become leaky or narrowed, hence the need for replacement. So tell us about the TAVR procedure then. How does it work?
Dr. Hussain: So the TAVR procedure is an excellent advancement in our capabilities. It essentially is a minimally invasive aortic valve replacement. We don’t have to perform a sternotomy or an incision. We are able to minimally invasively either through the groin artery or sometimes we use the upper artery of the arm, or even the carotid artery of your neck to gain access across the aortic valve. Using a variety of technologies, replace it either a balloon expandable or self-expanding tissue valve. Therefore, that takes away the need for prolonged hospitalization and a potentially harmful or risky procedure that is an open heart modality.
Host: This is amazing. So who is it that candidate for this procedure?
Dr. Hussain: In this initial phase of development of this strategy and technology, this technology was restricted to high risk inoperable patients who had a heart valve team evaluate them and determine that they would be at high risk of mortality and morbidity if they were to go under general anesthesia. The data and research and clinical experience has shown that this procedure is equally, or if not superior, to open heart surgery in patients that are now deemed intermediate risk or even low risk for open heart surgery. So I would think, in my own mind, that if anyone’s above the age of 80, I would recommend the TAVR procedure and not even consider open hearty surgery. Those who are younger, the heart valve team will determine what is the best modality of the therapy therapeutic procedure for that individual.
As the technologies become finer and smaller and easier to place in the body, it really opens up a wider assortment of patients that now should receive the TAVR procedure. People are usually referred for TAVR when they have symptoms, such as shortness of breath, fatigue, tightness in their chest, or the feeling that they're going to pass out. Or have passed out with an echocardiogram that shows that the valve has narrowed to a certain extent.
Host: So through those symptoms you were just mentioning—shortness of breath, fatigue, tightness in chest, feeling like you're going to pass out, or at one point or another already passing out. This is a way to help us determine whether or not we have healthy heart valves?
Dr. Hussain: Yes. Essentially anybody who has any of these types of symptoms should have an ultrasound of their heart performed. Many times they may be told that this is just part of aging, but we’ve discovered that many times it’s not related to just an age related fatigue. There’s an underlying valve issue that can relatively easily be rectified.
Host: So if you're feeling any of those symptoms, don’t delay. Get to the doctor. So let me ask you this. How long does this heart valve last then through the TAVR procedure?
Dr. Hussain: The valve is a bioprosthetic tissue valve, either porcine or bovine. The experience thus far is we know for sure that it would last at least eight years. Typically a surgically implanted tissue valve is thought to last about 10 years. Since TAVR was only started about seven or eight years ago, we only have that much data. We do anticipate that it will match any of the surgical longevities that are already known.
Host: Well Dr. Hussain, thank you so much. This has really been interesting. For more information about TAVR or to get hooked up with one of our providers, please visit osceolaregional.com. If you found this podcast helpful, please share it on your social channels and be sure to check out our entire podcast library for topics of interest to you. This is Helmet of Health, a podcast from Osceola Regional Medical Center. I'm Bill Klaproth. Thanks for listening.
Bill Klaproth (Host): Transcatheter aortic valve replacement, or TAVR, is a minimally invasive heart valve replacement procedure that can offer new hope to patients who have aortic valve stenosis and are at a high or extreme risk for open heart surgery. Pretty cool. So let’s learn more with Dr. Sayed Hussain, interventional cardiologist at Osceola Regional Medical Center’s Heart and Vascular Institute. This is Helmet of Health, a podcast from Osceola Regional Medical Center. I'm Bill Klaproth. Dr. Hussain, so tell me. Why do heart valves go bad?
Sayed Hussain, MD (Guest): There are many different varieties of reasons of why cardiac valves can degenerate and be compromised. Some are genetic congenital heart disease related, but many of these other conditions are acquired with the aging process. Conditions such as high blood pressure and other variety of comorbidities that can cause a valve to either become leaky or narrowed.
Host: Okay. So that’s what’s good to remember. When they become leaky or narrowed, hence the need for replacement. So tell us about the TAVR procedure then. How does it work?
Dr. Hussain: So the TAVR procedure is an excellent advancement in our capabilities. It essentially is a minimally invasive aortic valve replacement. We don’t have to perform a sternotomy or an incision. We are able to minimally invasively either through the groin artery or sometimes we use the upper artery of the arm, or even the carotid artery of your neck to gain access across the aortic valve. Using a variety of technologies, replace it either a balloon expandable or self-expanding tissue valve. Therefore, that takes away the need for prolonged hospitalization and a potentially harmful or risky procedure that is an open heart modality.
Host: This is amazing. So who is it that candidate for this procedure?
Dr. Hussain: In this initial phase of development of this strategy and technology, this technology was restricted to high risk inoperable patients who had a heart valve team evaluate them and determine that they would be at high risk of mortality and morbidity if they were to go under general anesthesia. The data and research and clinical experience has shown that this procedure is equally, or if not superior, to open heart surgery in patients that are now deemed intermediate risk or even low risk for open heart surgery. So I would think, in my own mind, that if anyone’s above the age of 80, I would recommend the TAVR procedure and not even consider open hearty surgery. Those who are younger, the heart valve team will determine what is the best modality of the therapy therapeutic procedure for that individual.
As the technologies become finer and smaller and easier to place in the body, it really opens up a wider assortment of patients that now should receive the TAVR procedure. People are usually referred for TAVR when they have symptoms, such as shortness of breath, fatigue, tightness in their chest, or the feeling that they're going to pass out. Or have passed out with an echocardiogram that shows that the valve has narrowed to a certain extent.
Host: So through those symptoms you were just mentioning—shortness of breath, fatigue, tightness in chest, feeling like you're going to pass out, or at one point or another already passing out. This is a way to help us determine whether or not we have healthy heart valves?
Dr. Hussain: Yes. Essentially anybody who has any of these types of symptoms should have an ultrasound of their heart performed. Many times they may be told that this is just part of aging, but we’ve discovered that many times it’s not related to just an age related fatigue. There’s an underlying valve issue that can relatively easily be rectified.
Host: So if you're feeling any of those symptoms, don’t delay. Get to the doctor. So let me ask you this. How long does this heart valve last then through the TAVR procedure?
Dr. Hussain: The valve is a bioprosthetic tissue valve, either porcine or bovine. The experience thus far is we know for sure that it would last at least eight years. Typically a surgically implanted tissue valve is thought to last about 10 years. Since TAVR was only started about seven or eight years ago, we only have that much data. We do anticipate that it will match any of the surgical longevities that are already known.
Host: Well Dr. Hussain, thank you so much. This has really been interesting. For more information about TAVR or to get hooked up with one of our providers, please visit osceolaregional.com. If you found this podcast helpful, please share it on your social channels and be sure to check out our entire podcast library for topics of interest to you. This is Helmet of Health, a podcast from Osceola Regional Medical Center. I'm Bill Klaproth. Thanks for listening.