The Hadassah Medical Center’s Heart Institute has performed its first Trans-catheter Aortic Valve Intervention (TAVI), a new nonsurgical procedure to treat aortic stenosis (AS), a severe degenerative disease which causes the narrowing of the aortic valve.
The aortic valve transmits blood from the heart to the rest of the body. Traditionally, the definitive therapy for patients with severe AS is valve replacement, performed via open-heart surgery. This is particularly problematic because AS typically affects the elderly and many are considered to be at high operative risk and, therefore, denied surgery. Through this new nonsurgical technique, a bioprosthetic valve is mounted on an expandable nitinol frame. This “CoreValve system” is advanced through a catheter from the groin to the appropriate location between the heart and the aorta, where it is released and starts to function immediately.
The Hadassah team, led by Prof. Chaim Lotan, head of the Heart Institute, and Dr. Haim Danenberg, Director of Interventional Cardiology, has performed the procedure on four patients, all of whom were awake during the procedure and out of bed on the same day. The team worked closely with Dr. Jean-Claude Laborde from France and Dr. Stephen Brecker from the United Kingdom.
All four patients recovered promptly. One patient, an 80-year-old lady with lung disease, who was not a candidate for open-heart surgery, commented: “I feel that the weights have been lifted from my heart. I have 70 great-grandchildren and now I’ll be able to visit each and every one of them.”
Studies to date indicate that the TAVI implant has an over 90 percent success rate. Currently, two TAVI devices have received European regulatory approval, but they have not yet been approved for use in the United States. Because the technology is so new, there are no data available on their long-term durability.