• San Antonio Regional Hospital's TAVR Procedure Offers New Hope to Cardiac Patients

    The Heart Center at San Antonio Regional Hospital in Upland is offering a promising alternative for patients with aortic valve stenosis who may not be candidates for traditional valve replacement surgery. Aortic valve stenosis is a narrowing of the heart’s aortic valve. The valve acts in a way that is similar to an old camera shutter— with several pieces (leaflets) that open and close. When the heart contracts, the aortic valve opens to allow blood to flow through. When the heart relaxes, the valve closes to prevent blood from leaking back into the aorta. In some patients, the leaflets in the aortic valve become stiff, reducing their ability to fully open and close and allow normal blood flow. This causes the heart to work harder to push blood through the aortic valve to the rest of the body. Eventually, the heart becomes weaker, increasing the risk for heart failure. TAVR (Transcatheter Aortic Valve Replacement) is considered a last option for patients who are elderly or have complicating medical issues which make open heart surgery too risky for traditional valve replacement. The San Antonio TAVR team includes cardiologists and cardiac surgeons who evaluate and manage these otherwise inoperable patients to determine whether they are candidates for TAVR. “After having good success in clinical trials on high risk patients, the TAVR procedure is now being used at select hospitals for high to moderate risk patients,” states Hossein Dehghani, MD, Medical Director of San Antonio’s Coronary Care Unit. Performed under general anesthesia in the hospital’s cardiac catheterization lab, TAVR is a less invasive procedure that allows physicians to perform the valve replacement through a small incision in the groin. The procedure requires a trained interventional cardiologist and a cardiothoracic surgeon working side by side to deploy the valve in the correct position. An artificial valve is inserted through a large catheter threaded up to the heart guided by X-ray. Once in place, a balloon at the end of the catheter is inflated to prepare the faulty aortic valve for replacement with the new valve. Recovery is minimal for most patients. The first two patients to receive the TAVR procedure at San Antonio—both elderly males—were released from San Antonio just a few days after the procedure. “TAVR offers an opportunity for a better quality of life to patients with aortic stenosis who cannot undergo open heart surgery,” states Nan Wang, MD, Director of Cardiothoracic Surgery. “Many times these patients are older and frail, so providing TAVR to our community allows them to receive this advanced care closer to home, in an environment where they are more familiar. We are grateful to be able to offer this highly specialized procedure here.”