Transcatheter Heart Valve Replacement for Severe Aortic Stenosis

Information for Professionals

Aortic stenosis (AS) is the most prevalent valvular heart disease and cardiovascular condition after coronary artery disease and hypertension. Acquired AS primarily affects the elderly and causes debilitating symptoms and decreased quality of life. Over time, progressive calcification and immobilization of the valve leaflets causes stiffening and narrowing of the aortic leaflets, scarring, impaired valve opening, reduced cardiac output and eventually, heart failure. In most cases, surgical valve replacement is the treatment of choice for patients with sever AS.

In January 2005, the Heart Centre was the first hospital in the world to develop a reproducible transfemoral aortic valve replacement for severe aortic stenosis through an incision in the artery in the leg. Since then, Dr. Webb and the Heart Centre team have performed over 100 percutaneous aortic valve replacements. In October 2005, Drs. Cheung, Lichtenstein, Ye and Webb, and the Heart Centre cardiac surgery and interventional cardiology team were also the first to begin using a similar catheter technique to replace the aortic valve through a small incision in the chest without using cardio-pulmonary by-pass. To date, this team has performed over 50 transapical valve replacements.

Although the early results of this innovative approach are promising, transcatheter aortic valve replacement remains suitable only for patient in whom the risks of routine open heart surgery are excessive. Research is presently underway to study how this new approach compares to existing treatment options.

More information about the valve prosthesis that the interventional cardiology and cardiac surgery teams are presently using is available from Edwards LifeSciences (link to http://www.edwards.com/Products/PercutaneousValves/SapienTHV.htm)