May 14, 2024
Mayo Clinic cardiovascular specialists expand on innovative advances for treating aortic valve disease. The experts in surgical solutions for complex cases also perform minimally invasive procedures.
"We've gained major success in the last 15 years with catheter procedures, especially through the transcatheter aortic valve replacement (TAVR) technology," says Hector I. Michelena, M.D., a cardiologist at Mayo Clinic in Rochester, Minnesota. The procedure allows patients to leave the hospital within 1 to 2 days.
Traditionally, surgeons had to open the chest, cut out the old valve and sew in a new valve. "We are now able to replace a patient's diseased aortic valve through a catheter in the groin with no incision," says Arman Arghami, M.D., a cardiovascular surgeon at Mayo Clinic in Rochester. "The TAVR allows us to shrink a prosthetic valve and put it through a catheter from the groin into an artery, and then push it all the way to the heart, let it deploy, and squeeze the old valve out and replace it with the new one."
New advances, more candidates
While at the cutting edge of technological advancements with TAVR, Mayo Clinic prioritizes patient safety and long-term benefits above all. "Industry continues to evolve with a specialty and newer iterations of transcatheter heart valve have been created to improve both durability and longevity of the valve prosthesis," says Phillip G. Rowse, M.D., a cardiovascular surgeon at Mayo Clinic in Rochester.
"We actively participate in studies exploring the latest iterations of TAVR devices, such as alignment of prosthetic leaflets that not only aim to enhance immediate outcomes post-treatment, but are also designed to better prepare patients for potential future therapies they may require," says Dr. Arghami.
"Mayo Clinic is now doing TAVR in some bicuspid aortic valve patients, and TAVR is being studied for leaky aortic valves," says Dr. Michelena. Initially used for patients too sick to undergo surgery, today TAVR procedures help more patients without operating. "TAVR is benefitting low-risk, intermediate-risk and high-risk patients," says Dr. Rowse.
Experts in redo operations
Mayo Clinic cardiovascular experts specialize in complex repeat or redo surgeries when a patient previously had several operations or multiple valve interventions. "We receive patients with many complicated medical problems. A common issue we see frequently is multiple valve problems, for example, leaky mitral valve, leaky tricuspid valve, an obstructed aortic valve — potentially all in combination," says Dr. Rowse. "We do repeat operations daily and are very comfortable offering redo surgeries for patients where multiple valves need to be intervened."
Patient-friendly streamlined approach
Mayo Clinic values patients' and their families' time and designed a streamlined approach for care.
- Mayo Clinic schedules all necessary appointments and tests. The team caters to patients traveling from afar. Patients can undergo CT imaging, lab work and an angiogram in rapid succession.
- Treatment occurs within a week. "The efficiency of this process allows for patients to travel back home just a day or two after their TAVR procedure, making it an exceptionally patient-friendly model," says Dr. Arghami.
Collaborative practice
Patients gain a holistic understanding of their treatment choices. "Mayo's unique collaborative practice model offers patients simultaneous consultations with a surgeon and a cardiology interventionalist. This ensures a comprehensive and unbiased discussion about treatment options, placing the patient's needs and perspectives first," says Dr. Arghami.
Mayo Clinic Cardiovascular Medicine supports referring physicians with patient concerns. That may mean reviewing records ahead of time and providing expert recommendations often without the patient on site.
"Working with local physicians is an important part of this because many patients come from far away," says Dr. Michelena. "We're in clear communication with the doctors taking care of patients when they return to their city or hometown. We send comprehensive digital notes and assessment and plans." This personal attention reflects Mayo Clinic Cardiovascular Medicine's commitment to innovation, collaboration and patient-centered care.
For more information
Refer a patient to Mayo Clinic.