Transcatheter Heart Valve Therapies for the Aortic Valve
As one of the highest volume and most experienced transcatheter aortic heart valve replacement (TAVR) programs in the nation, Northwestern Medicine continues to expand its Transcatheter Heart Valve Program by offering a wide array of minimally invasive commercially available therapies and clinical trial options to treat the aortic valve, including TAVR for low-risk patients.
Transcatheter Aortic Heart Valve Therapies: Now Available for Low-Risk Surgical Patients
The Transcatheter Heart Valve Program at Northwestern Medicine began offering transcatheter aortic valve replacement (TAVR) in 2008. For some patients with aortic stenosis, TAVR is an alternative treatment to open heart valve surgery. Since the early days of TAVR, Northwestern Medicine has been a leader in spearheading numerous TAVR clinical trials, helping to expand this therapy in a safe and effective way.
In 2019, the results of two transcatheter aortic valve clinical trials1 –PARTNER 3 and EVOLUT– suggest that low-risk patients do as well or better with TAVR than with open heart valve surgery to replace a diseased aortic valve. TAVR is not only an option for patients considered medium- or high-risk for open heart valve surgery, but is also an option for younger, healthier, low-risk patients. As one of the top enrolling sites in the United States for the PARTNER 3 clinical trial, we are proud to be leaders in innovating treatment options with easier recoveries and superior results for our patients.
Today, Northwestern Medicine offers a variety of commercially available (FDA approved) TAVR procedures and clinical trial options for the aortic valve, allowing us to tailor treatment precisely to the individual patient’s needs. TAVR therapies are offered at both Northwestern Memorial Hospital and Central DuPage Hospital.
Transcatheter Aortic Valve Commercially Available (FDA Approved) Treatment Options
Transcatheter procedures allow the procedure to be performed while the patient’s heart is still beating, eliminating the need for a “heart bypass” machine and its associated risks. Due to the minimally invasive nature of transcatheter procedures, patients tend to recover faster and experience an improvement in symptoms soon after the procedure is completed. The Transcatheter Heart Valve Program at Northwestern Medicine offers two aortic valve transcatheter treatment options: TAVR and transcatheter aortic valve in valve replacement.
Transcatheter Aortic Valve Replacement (TAVR): A minimally invasive treatment option for patients with aortic valve stenosis. A stenotic aortic valve is narrowed, restricting blood flow from the heart. During TAVR, an interventional cardiologist and/or a cardiac surgeon inserts a catheter (tube) in the body through an artery. The TAVR valve is compressed and advanced by a catheter through an artery until it reaches the diseased aortic valve. A balloon on the catheter expands to secure the TAVR valve within the diseased aortic valve and then the catheter is removed. The secured TAVR valve remains in place pushing the diseased valve out of the way, allowing the TAVR valve to take over the job of regulating blood flow from the heart.
Transcatheter Aortic Valve in Valve Replacement: A minimally invasive TAVR procedure for patients who have had previous open heart valve surgery to replace the aortic valve with a bioprosthetic/tissue valve that is now failing. Instead of replacing the failing aortic valve with another open heart valve surgery, the failing aortic valve is replaced by placing and securing a TAVR valve inside the failing aortic valve.
During aortic valve in valve replacement, an interventional cardiologist and/or a cardiac surgeon inserts a catheter (tube) through an artery in the body. The TAVR valve is compressed and advanced by a catheter through an artery until it reaches the failing aortic valve. A balloon on the catheter expands and secures the TAVR valve within the failing aortic valve. The catheter is then removed and the TAVR valve remains in place pushing the failing aortic valve out of the way, allowing the TAVR valve to take over the job of regulating blood flow from the heart.
Transcatheter Aortic Valve Clinical Trial Options
Researchers at Northwestern Medicine conduct clinical trials that provide access to innovative therapies for the treatment of heart and vascular disease. Participating in a clinical trial is an opportunity to evaluate the effectiveness and safety of medications or study devices. The study devices and delivery systems used in the following clinical trials are investigational (experimental), which means they are not approved for commercial use by the U.S. FDA.
PARTNER 3 Aortic Valve in Valve: enrolling patients who have an existing bioprosthetic aortic valve that is failing and needs to be replaced. Eligible participants will receive the SAPIEN 3 transcatheter aortic heart valve (study device) to replace the failing bioprosthetic aortic valve.
Northwestern Medicine is also among the most experienced programs in the country for transcatheter treatment options for the mitral valve and tricuspid valve.
Meet the Transcatheter Aortic Valve Therapies Team
|Northwestern Medicine Bluhm Cardiovascular Institute is a nationally recognized destination for those who require highly specialized cardiovascular care.||Meet the Teams
Northwestern Medicine Transcatheter Aortic Featured Publications
- Kang DY, Ahn JM, Kim JB, Yeung A, Nishi T, Fearon W, Cantey EP, Flaherty JD, Davidson CJ, Malaisrie SC, Park SY, Yun SC, Ko E, Park H, Lee SA, Kim DH, Kim HJ, Kim JB, Choo SJ, Park DW, Park SJ. Inter-racial differences in patients undergoing transcatheter aortic valve implantation. Heart. 2022 Feb 2:heartjnl-2021-320364. doi: 10.1136/heartjnl-2021-320364. Epub ahead of print. PMID: 35110384.
- Park H, Ahn JM, Kang DY, Kim JB, Yeung AC, Nishi T, Fearon WF, Cantey EP, Flaherty JD, Davidson CJ, Malaisrie SC, Kim S, Yun SC, Ko E, Lee SA, Kim DH, Kim HJ, Kim JB, Choo SJ, Park DW, Park SJ. Racial Differences in the Incidence and Impact of Prosthesis-Patient Mismatch After Transcatheter Aortic Valve Replacement. JACC Cardiovasc Interv. 2021 Dec 27;14(24):2670-2681. doi: 10.1016/j.jcin.2021.08.038. Epub 2021 Nov 24. PMID: 34838464.
- Davidson LJ, Davidson CJ. Transcatheter Treatment of Valvular Heart Disease: A Review. JAMA. 2021;325(24):2480–2494. doi:10.1001/jama.2021.213
- Cantey EP, Chang KY, Blair JEA, Brummel K, Sweis RN, Pham DT, Aid A-C, Churyla A, Ricciardi MJ, Malaisrie SC, Davidson CJ, Flaherty JD. Impact of Loop Diuretic Use on Outcomes Following Transcatheter Aortic Valve Implantation. American Journal of Cardiology. 131:67-73;2020.
- Howard TM, Cantey EP, Abdutaleb A, Ricciardi MJ, Sweis RN, Pham DT, Churyla A, Malaisrie SC, Davidson CJ, Flaherty JD. Transcatheter Aortic Valve Replacement Outcomes Based on the Presence of Chronic Total Occlusion. Cardiovascular Revasc Medicine. 21:1305-10;2020.
- Kaplan RM, Yadlapati A, Cantey EP, Passman RS, Gajjar M, Knight BP, Sweis R, Ricciardi MJ, Pham DT, Churyla A, Malaisrie SC, Davidson CJ, Flaherty JD. Conduction Recovery Following Pacemaker Implantation After Transcatheter Aortic Valve Replacement. Pacing & Clinical Electrophysiology. 42:146-52;2019.
- Blair JEA, Atri P, Friedman JL, Thomas JD, Brummel K, Sweis RN, Mikati I, Malaisrie SC, Davidson CJ, Flaherty JD. Diastolic Function and Transcatheter Aortic Valve Replacement. Journal of the American Society of Echocardiography. 30:541-51;2017.
- Cubeddu RJ, Asher CR, Lowry AM, Blackstone EH, Kapadia SR, Alu MC, Thourani VH, Mack MJ, Kodali SK, Herrmann HC, Forcillo J, Babaliaros VC, Devireddy CM, Malaisrie SC, Davidson CJ, Jaber WA, Leon MB, Svensson LG; PARTNER Trial Investigators. Impact of Transcatheter Aortic Valve Replacement on Severity of Chronic Kidney Disease. J Am Coll Cardiol. 2020 Sep 22;76(12):1410-1421. doi: 10.1016/j.jacc.2020.07.048. PMID: 32943158.
- Kislitsina ON, Szlapka M, McCarthy PM, Davidson CJ, Flaherty JD, Sweis RN, Kruse J, Andrei AC, Cox JL, Malaisrie SC. Unique technical challenges in patients undergoing TAVR for failed aortic homografts. J Card Surg. 2021 Jan;36(1):89-96. doi: 10.1111/jocs.15176. Epub 2020 Nov 10. PMID: 33170533.
*Bolding of author’s name indicates Northwestern Medicine and/or Northwestern University Feinberg School of Medicine faculty.
1. Transcatheter Aortic-Valve Replacement with a Balloon-Expandable Valve in Low-Risk Patients. N Engl J Med, 2019.