Aortic stenosis (narrowing) is a potentially life-threatening condition. The aorta is the main artery carrying blood from the heart to the rest of the body. When blood leaves the heart, it flows through the aortic valve, into the aorta. In aortic stenosis, the aortic valve does not open fully. This condition decreases blood flow from the heart. In patients in whom the stenosis progresses and becomes severe, the result is a life-threatening condition. Aortic stenosis is one of the common aortic valve problems, along with aortic regurgitation (leakage), that we treat in different ways at the Valve Center. The 2011 FDA approval of the Sapien aortic valve replacement device, which can be passed "over a wire" into the heart without major "open heart" surgery, represents a breathtaking advance in the way heart surgery is performed to treat aortic stenosis. It is the first artificial aortic heart valve placed without open heart surgery.
What Is the Transcatheter Aortic Valve Replacement (TAVR) Program?
The Stony Brook Valve Center offers new hope for high-risk patients with severe symptomatic aortic stenosis in need of valve replacement surgery. Without valve replacement, studies indicate that more than half of all patients with severe aortic stenosis will not survive an average of two years. Unfortunately, many of these patients are too ill to undergo open valve replacement surgery, still considered the gold standard treatment.
But now there's a new, less invasive approach — and with it, hope — even for patients with significant other medical issues. Stony Brook University Hospital is one of a select number of sites in the United States to offer the new minimally invasive procedure called transcatheter aortic valve replacement (TAVR) or implantation (TAVI) that uses the Sapien transcatheter heart valve.
Our TAVR team performs the transfemoral TAVR procedure (going through artery in groin to heart) and the transapical TAVR procedure (going between ribs to heart). Use of the two different procedures allows for more patients to be candidates for this life-saving valve replacement, as one may be feasible when the other is not.
The innovative procedure delivers a replacement valve via catheter while the heart is still beating. Clinical trial data is promising: The two-year, all-cause mortality rate is 43% compared with 68% for patients treated medically. Recovery time averages from one to two weeks.
Patient selection and follow-up care involve a collaborative effort between referring physicians and our valve specialists.
Stony Brook's TAVR program is leading the way in the new era in heart surgery, where valve surgery can be performed without the surgery. Our multidisciplinary team of physicians includes two heart surgeons and four cardiologists — all with special expertise in valve disease and treating aortic stenosis (click on the Our Team tab above).
Our program is patient-focused in every aspect, from patient selection to procedure planning to treatment and postoperative care. Indeed, the care provided at the Valve Center is distinguished by our team approach, together with easy access to our valve specialists and excellent communication with referring physicians. In most cases, patients are seen at the Valve Center within one week of referral.
If you are a patient with severe aortic stenosis, or if you are a physician caring for a patient with this condition who could benefit from further evaluation, please call 631-638-2101 to make an appointment, or to obtain more information about our TAVR program.
Our multidisciplinary TAVR team has years of training and experience in cardiology including interventional cardiology and in cardiothoracic surgery including valve surgery. This enables us to use the TAVR technology effectively in treating aortic stenosis and to provide comprehensive care for patients. Our team includes:
- Harold A. Fernandez, MD - Cardiothoracis Surgery
- Luis Gruberg, MD - Interventional Cardiology
- Sandeep Gupta, MD - Co-Director, Valve Center, Cardiothoracic Surgery
- Allen Jeremias, MD - Interventional Cardiology
- Smadar Kort, MD - Director, Valve Center, Cardiology
- James R. Taylor Jr., MD - Cardiothoracic Surgery
- Jonathan B. Weinstein, DO - Interventional Cardiology
Click here to view Frequently Asked Questions (FAQs) for the TAVR Program.