Northwestern Medicine First in Illinois to Perform TAVR Procedure on Low-Risk Patient
Northwestern Memorial Hospital August 19, 2016
Minimally invasive valve replacement becoming an option for more patients through research
CHICAGO, IL – Robert Bayer’s cardiologist detected what he could not feel — a heart murmur that indicated a slowly deteriorating aortic valve.
“This spring my cardiologist and I decided to do something while I was still in good health, and he referred me to Northwestern and Dr. Patrick McCarthy,” Bayer said. “I was told I had two possible options — open heart surgery or trying to be part of a clinical trial of a less invasive valve replacement. I was so happy to hear this trial was available.”
Bayer, 72, of Lowell, Ind., recently became the first low-risk patient in Illinois to undergo the TAVR procedure, or Transcatheter Aortic Valve Replacement, as part of the Partner 3 clinical trial. Previously, TAVR was only offered to high-risk or intermediate-risk patients who were not ideal candidates for open-heart surgery. This new trial will now expand TAVR as an option for patients who are not at high risk of mortality or complications from open-heart surgery, to reap the benefits of valve replacement without undergoing surgery. In TAVR, cardiologists thread the new valve to the heart via a catheter, or tube, inserted in the patient’s groin or a small incision under the patient’s ribs. In a Cardiac Cath Lab, the new valve is steered into the diseased valve, replacing it.
“Since the inception of our TAVR program in 2008, we have strived to match the best treatment for each individual patient,” said Charles Davidson, MD, Co-Principal Investigator for the Partner 3 trial and clinical chief of cardiology at Northwestern Memorial Hospital, who performed the procedure on Bayer with Duc Thinh Pham, MD, surgical director of the Center for Heart Failure at Northwestern Memorial. “We are excited to be one of the first centers to offer TAVR for a broader group of low risk patients through this clinical trial. The technology has demonstrated superior outcomes to surgery in intermediate risk patients and now will investigate how it compares to surgery in patients at low risk.”
The TAVR heart team at Northwestern Memorial also includes S. Chris Malaisrie, MD, Co-Principal Investigator for the Partner 3 trial and co-director of the thoracic aortic surgery program at the Bluhm Cardiovascular Institute, and James Flaherty, MD, director of the CCU as well as other interventional cardiologists and surgeons.
Physicians at Northwestern Medicine’s Bluhm Cardiovascular Institute have completed more than 500 transcathether valve replacements to correct severe, symptomatic aortic stenosis, which narrows the valve, reducing blood flow and causing the heart to work much harder. This can lead to extreme fatigue, shortness of breath, dizziness, and chest pain. Results from earlier clinical trials on high and intermediate-risk TAVR patients show positive outcomes that are comparable to, or in some cases, better than open-heart surgery.
For Bayer, participating in the Partner 3 low-risk TAVR trial meant that he was randomly selected to either receive the transcathether valve or to replace the valve through open-heart surgery. Northwestern Medicine Memorial is one of 50 sites in the United States expected to enroll up to 1,300 patients in Partner 3.
In the first seven months of 2016, Bluhm Cardiovascular Institute cardiologists and cardiac surgeons have been the first in Illinois and the Midwest to perform transcathether, minimally invasive valve repairs or replacements through three separate clinical trials — Partner 3, SCOUT (transcatheter tricuspid annuloplasty) and TIARA (transcatheter mitral valve replacement) trials.
“The results of Partner 3 and all of our transcatheter trials potentially will dramatically alter the options for treatment and recovery after the procedure.” said Patrick McCarthy, MD, executive director of the Bluhm Cardiovascular Institute (BCVI) and the Heller-Sacks professor of cardiothoracic surgery at Northwestern University Feinberg School of Medicine. “While open heart surgery today is the preferred option for most patients, physicians at BCVI have been at the forefront of developing transcathether valve therapies and in 10 years likely it will be the preferred treatment for most patients.”
Bayer was home from the hospital 2 days after the procedure, with plans to be back on the golf course in a couple weeks.
“This was the only thing wrong with me, this valve,” he said. “The rest of the heart, everything else is fine.”
Northwestern Medicine’s Bluhm Cardiovascular Institute is one of the top 10 national programs for cardiology and heart surgery, according to U.S. News & World Report, and consistently ranked the top cardiovascular program in Chicago, Illinois and the surrounding states. Learn more information about Northwestern Medicine’s top ranked cardiovascular care or call 312.NM.HEART.
Read more about the clinical trials at the Bluhm Cardiovascular Institute.
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