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Transcatheter Aortic Valve Replacement

Innovative Heart Care Procedure, Close to Home

If you’ve been diagnosed with aortic stenosis, but are considered an intermediate or high risk for surgery, transcatheter aortic valve replacement (TAVR) may be the solution you need to greatly improve your condition and quality of life. At Saint Vincent Hospital, our multidisciplinary team is able to offer this lifesaving procedure to otherwise inoperable patients in our state-of-the-art hybrid catheterization room.

One of the features that makes our TAVR program unique is the ability to perform the procedure under moderate sedation rather than general anesthesia. This approach lessens the risk associated with anesthesia.

What is TAVR?

TAVR is a newly developed procedure used to treat aortic stenosis, a condition that occurs when the one-way valve between the pumping chamber of the heart and the aorta becomes thickened and calcified, not opening well. In less serious cases, patients are able to undergo valve replacement surgery to help the condition. For patients with severe valve narrowing and older adults, the surgery risk may be too high. That’s where TAVR comes in.

Over the last few years, TAVR has been developed to provide a minimally invasive solution for high-risk patients. During this procedure, a new valve is placed through the blood stream, and a new valve is expanded within the patient’s own diseased valve. Usually this procedure is done the femoral (groin) blood vessels, but if you have extensive blood vessel disease, it may need to be done through an incision in the chest to place the new valve directly through the heart muscle.

Am I a Candidate?

TAVR is only for patients who are at high or intermediate risk for surgery and for those who are unable to have surgery. This procedure is only for aortic stenosis, not aortic regurgitation, as the calcification of the diseased valve is used to keep the new valve in place. TAVR requires that the diseased valve have three leaflets, not congenitally abnormal bicuspid (two leaflet) valves. TAVR is not approved for low-risk patients at this time. Surgical valve replacement is currently offered to patients considered to be at low risk because of the excellent long-term benefits of surgery.

TAVR Process: What to Expect

If your doctor suspects that you have severe aortic stenosis, especially if you are symptomatic, an echocardiogram is usually performed.  A referral to our Advanced Structural and Valvular Heart Disease program can provide you with an evaluation by our TAVR cardiologists and cardiothoracic surgeons.

We’ll review the outside echocardiogram or obtain one at Saint Vincent Hospital. If our team believes that your surgical risk is high and you might do better with a TAVR procedure, additional testing, including a specialized computed tomographic angiogram and cardiac catheterization, will be performed. Once additional testing has been completed, a follow-up evaluation will occur to review the testing results and discuss TAVR procedure options.

Preparing for the Procedure

The procedure is usually performed under general anesthesia under the supervision of a cardiac anesthesiologist. During preadmission testing, you’ll meet with an anesthesiologist who will also review your history, medications and lab tests. Some patients require admission the day before the procedure and others may be admitted the morning of the procedure. Instructions on preparing and arriving for your procedure will be given to you in advance.

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Nutrition and Your Heart: 10 Healthy Eating Tips

Mom and Daughter holding groceriesScience is discovering what we’ve been told by our mothers for decades: eating a diet rich in fruits and vegetables may be the best preventative medicine of all. In fact, the American Heart Association says “a healthy diet and lifestyle are your best weapons to fight cardiovascular disease.”

A study by University of California, San Francisco, also confirmed this. It focused on people who had suffered a heart attack and then switched to a low-fat diet, started exercising regularly, stopped smoking, lowered their stress and increased their social connections. It showed that most of the participants lowered their blood pressure and cholesterol levels, reversed some of the blockage in their arteries and even lowered their blood sugar.

So what can you do to eat healthier and decrease your risk for cardiovascular disease and other chronic health conditions? Start here with these 10 tips:

10 Healthy Eating Tips for Your Heart

  1. Have at least two servings of fish per week, especially those with omega-3 fatty acids, such as salmon, trout and herring.
  2. Get at least five servings of fruits and vegetables per day.
  3. Eat whole grain breads and cereals in lieu of white bread, rice and noodles.
  4. Get your soluble fiber. Beans, oats, barley and prunes are a few examples.
  5. When eating meat, choose lean cuts of beef, pork or skinless chicken breast.
  6. Add healthy fats and oils to your diet. These include olive oil, canola oil, nuts, avocados, olives and foods that have natural oils over those made with hydrogenated fats.
  7. Cut out foods that are high in saturated fats, such as full fat whole milk and other dairy products, high fat cuts of meat and tropical oils, and trans fat that is typically found in margarine, baked goods, crackers and fried fast foods.
  8. Make sure to get plenty of fluids. Drink up: water, juice (non-sugary ones) and low-fat milk.
  9. Limit sodium intake and read food labels. The American Heart Association recommends lowering salt consumption to 1,500 mg / day. To put that in perspective, ¼ teaspoon of salt is equal to 575 mg of sodium and 1 teaspoon of salt equals 2,300 mg of sodium.
  10. Don’t forget the antioxidant-containing foods. Some good food sources of antioxidants include green leafy vegetables, legumes, papaya seeds, soybeans, sweet potatoes, wheat germ, carrots and tomatoes.

Taking these recommendations to heart could protect yours today and down the road. Plus, as a bonus, you might just see an increase in energy to fuel more physical activity. That’s a win-win-win.

SOURCES: 

https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/aha-diet-and-lifestyle-recommendations

http://time.com/5534352/food-best-medicine/

https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/sodium/sodium-and-salt

https://my.clevelandclinic.org/health/articles/16740-antioxidants-vitamin-e-beta-carotene--cardiovascular-disease