Oct 30, 2017
New York - 

Since its first U.S. use in 2002, NewYork-Presbyterian has helped pave the way for the advancement of transcatheter aortic valve replacement (TAVR) for cardiac patients who are in need of a new heart valve, but are not candidates for open-heart surgery.

TAVR is used for patients with aortic stenosis, or narrowing of the aortic valve, which prevents blood from flowing properly. Roughly five percent of people over the age of 75 will experience aortic stenosis, and many will require a heart valve replacement.

Prior to the advent of TAVR, the only treatment for severe aortic stenosis was open heart surgery—yet many of those same patients would not survive this surgery.

Now, many patients with aortic valve stenosis have a minimally invasive option through TAVR. In the TAVR procedure, a replacement heart valve is threaded on a specially designed catheter through the groin and advanced to the heart. Patients may be discharged from the hospital within 48 hours. There is no surgical wound beyond the small puncture mark where the catheter was inserted.

In honor of NewYork-Presbyterian’s 15-year TAVR anniversary, here are 15 ways NewYork-Presbyterian has pioneered this groundbreaking procedure:

  1. Over the past 15 years, NewYork-Presbyterian has participated in 12 clinical trials that helped TAVR achieve FDA approval and continue to advance.
  2. In 2005, NewYork-Presbyterian/Columbia University Irving Medical Center was one of three clinical sites in the U.S. for the first feasibility trial of the Cribier-Edwards percutaneous aortic heart valve, an early incarnation of the heart valve used in TAVR.
  3. Dr. Martin Leon, director of the Center for Interventional Vascular Therapy at NewYork-Presbyterian/Columbia and professor of medicine at Columbia University College of Physicians and Surgeons, and Dr. Craig R. Smith, surgeon-in-chief at NewYork-Presbyterian/Columbia and the Johnson & Johnson Distinguished Professor in the Department of Surgery, Valentine Mott Professor of Surgery, and chair of the Department of Surgery at Columbia University College of Physicians and Surgeons, led a team as part of a 26-center Placement of Aortic Transcatheter Valve (PARTNER) clinical research trial that tested the valve. The results, published in the October 21, 2010 issue of The New England Journal of Medicine (NEJM), showed that TAVR can improve survival rates and the quality of life for patients with severe aortic stenosis, compared with the standard therapy.
  4. The PARTNER trials have led to more than 200 published articles, including several in NEJM and The Lancet.
  5. In 2011, NewYork-Presbyterian/Columbia University Irving Medical Center physicians conducted the clinical trial that led to FDA approval of the Edwards SAPIEN TAVR device, and performed the first procedure after its approval. This was the first commercial approval for a transcatheter device enabling TAVR in the United States.
  6. In 2016, NewYork-Presbyterian cardiologists co-authored a study presented at the American College of Cardiology that found the use of the newer Edwards SAPIEN 3 Transcatheter Heart Valve resulted in lower mortality rates. SAPIEN 3 is the newest generation of SAPIEN transcatheter heart valves.
  7. NewYork-Presbyterian/Columbia University Irving Medical Center and NewYork-Presbyterian/Weill Cornell Medical Center clinician researchers are currently exploring TAVR as an option for patients with failing surgically implanted bioprosthetic (consisting of an animal part or tissue) valves.
  8. NewYork-Presbyterian has trained more than half of the physicians performing TAVR in the nation.
  9. Seventy-five percent of TAVR patients at NewYork-Presbyterian/Columbia University Irving Medical Center bypass the ICU and go directly from the Cardiac Catheterization Laboratory to an observation unit for recovery, a testament to the simpler and shorter recovery phase following the procedure.
  10. While the stroke rate for TAVR is less than that of open-heart surgery, NewYork-Presbyterian physicians have been leading the way in the evaluation of cerebral embolic protection devices (EPDs). EPDs capture and remove debris that may become dislodged during procedures, helping reduce potential brain injury from strokes that may occur.
  11. In clinical trials, NewYork-Presbyterian physicians found that TAVR caused fewer cases of kidney damage and life-threatening bleeding compared to open-heart surgery.
  12. In addition to NewYork-Presbyterian/Columbia University Irving Medical Center and NewYork-Presbyterian/Weill Cornell Medical Center, TAVR is also available at our NewYork-Presbyterian Brooklyn Methodist Hospital regional hospital. Additionally, we have recently begun evaluating patients for TAVR at NewYork-Presbyterian Lawrence.
  13. With TAVR now available for increasingly lower-risk operative patients, NewYork-Presbyterian/Columbia University Irving Medical Center and NewYork-Presbyterian/Weill Cornell Medical Center physicians are working on valve-in-valve TAVR, which may help with the management of these patients in the long term.
  14. NewYork-Presbyterian is one of the top implanters for TAVR in the nation, performing more than 500 procedures per year.
  15. To date, NewYork-Presbyterian has performed more than 4,000 TAVR procedures in total across its Columbia University Irving Medical Center and Weill Cornell Medical Center campuses.

For more information about NewYork-Presbyterian and TAVR, visit http://www.nyp.org/journeytotheheart/.

NewYork-Presbyterian

NewYork-Presbyterian is one of the nation’s most comprehensive, integrated academic healthcare delivery systems, whose organizations are dedicated to providing the highest quality, most compassionate care and service to patients in the New York metropolitan area, nationally, and throughout the globe. In collaboration with two renowned medical schools, Weill Cornell Medicine and Columbia University Medical Center, NewYork-Presbyterian is consistently recognized as a leader in medical education, groundbreaking research and innovative, patient-centered clinical care.

NewYork-Presbyterian has four major divisions:

  • NewYork-Presbyterian Hospital is ranked #1 in the New York metropolitan area by U.S. News and World Report and repeatedly named to the Honor Roll of “America’s Best Hospitals.”
  • NewYork-Presbyterian Regional Hospital Network comprises hospitals and other facilities in the New York metropolitan region.
  • NewYork-Presbyterian Physician Services, which connects medical experts with patients in their communities.
  • NewYork-Presbyterian Community and Population Health, encompassing ambulatory care network sites and community healthcare initiatives, including NewYork Quality Care, the Accountable Care Organization jointly established by NewYork-Presbyterian Hospital, Weill Cornell Medicine and Columbia.

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