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Surgeon Q&A: What is the Latest Research on Less Invasive Aortic Valve Surgery?

By Adam Pick on April 5, 2016

Eileen Chen, who is a member of our Facebook community, recently asked me, “Hi Adam, What is the latest research on less invasive aortic valve surgery?”

To answer Eileen’s question, I was very lucky to interview Dr. Allan Stewart during the Heart Valve Summit conference. So you know, Dr. Stewart is an excellent surgeon (and super nice guy) who has successfully treated over 100 patients from our community — including Christine Pittelli, Bill Easton, William Brogna and many others. 🙂

Here’s how Dr. Stewart answered Eileen’s question…

I hope this video helped Eileen (and perhaps you) learn more about less invasive aortic valve surgery techniques. I want to thank Eileen for her question. I also want to extend a humongous thanks to Dr. Allan Stewart for his continued support of our patient community.

Keep on tickin!
Adam

P.S. For the hearing impaired members of our community, I have provided a written transcript of this interview below.

Adam: Hi, everybody! It’s Adam with HeartValveSurgery.com. I’m here at the Heart Valve Summit in Chicago, Illinois, and I am thrilled to be with Dr. Allan Stewart. Dr. Stewart, thanks for being with us.

Dr. Stewart: My pleasure, Adam. Good to see you.

Adam: We are answering your questions that you submitted at our Facebook page. We’re going to answer a question, Dr. Stewart, from Eileen Chan. She says, “I’m looking into learning about any new research on less invasive aortic valve surgery.” Can you share about what you’re doing in the hospital these days?

Dr. Stewart: Absolutely, Adam! As we really evolve with new technology and new techniques, there’s a spectrum of less invasive surgery. It’s not necessary anymore to make a foot-long cut down the center of the breastbone and open it up; the incision you had many years ago. We’ve evolved now, and we have better techniques and better technology.

A standard aortic open heart surgery is still done with a chest incision, but the chest incision is only about five centimeters, about two and a half, three inches long. Now there are two options for that. One option is right through the breastbone at the top, where we make an upside down ‘T’, but the skin incision is very tiny and we put it together with titanium plates. That way you can get back to function very, very quickly in life, and you won’t alarm in the airport.

The other option is to go right through the side of the chest. Now, this is not a cosmetically appealing option to a woman because it’s right into the breast tissue. For a woman such as Eileen, I would favor the tiny incision down low. She can still wear the plunging neck gowns and the scar won’t show.

Now, I don’t know Eileen’s age but the other options available for less invasive surgery is TAVR, which we have a very robust program.

Adam: Dr. Stewart, for people who don’t know what TAVR means, can you explain that what technology is?

Dr. Stewart: TAVR is obviously an acronym. TAVR means trans-aortic valve replacement — transcatheter. What transcatheter means is that the valve is not implanted with open-heart surgery; the valve is implanted through a neostick in the groin. Patients are normally away; they’re not even asleep for it anymore. It takes about two hours to do and the patients are home usually in two or three days. That’s how you and I will have our heart valves replaced in 20 years, but it’s something that’s reserved for elderly people right now and patients who are at high to intermediate risk for surgery.

As time goes on and more information is given to us, we’re now backing that risk profile down so that that’s going to be the standard of care soon for everyone.

Adam: Well, Dr. Stewart, as always, thanks for your support of this community, all the educational support, of course the care that you’re giving to all the great people out there. Thanks for what you do!

Written by Adam Pick
- Patient & Website Founder

Written by Adam Pick - Patient & Website Founder

Adam Pick is a heart valve patient and author of The Patient's Guide To Heart Valve Surgery. In 2006, Adam founded HeartValveSurgery.com to educate and empower patients. This award-winning website has helped over 10 million people fight heart valve disease. Adam has been featured by the American Heart Association and Medical News Today.

whatever says on April 5th, 2016 at 10:05 pm

I think you mean to write, patients are normally awake.

Believe me, I wish it were away. I’d much prefer to be away than awake for that.

Eliza Hadjisotiriou Wilson says on April 6th, 2016 at 12:02 am

Many thanks for theinformation…can it be the same procedure for the mitral valve?

Adam says on April 6th, 2016 at 8:40 am

Hey Eliza, If you are asking if a TAVR-like approach can work for the mitral valve, the answer is yes. Watch this video to learn about a feasibility study for the a new TMVR device – https://www.youtube.com/watch?v=dkWzwz8ferk.

David R Robbins says on April 6th, 2016 at 11:19 am

I agree…put me to sleep for that one. However, I am not a candidate after 2 aortic valve replacements with a mechanical valve.

Bud Marchlewski says on May 4th, 2016 at 5:28 pm

Hi Adam, I have a question regarding TAVR and a patient being approved for the procedure. Lets say hypothetically that an elderly patient under the care of a cardiologist is determined to be too high-risk for open-heart aortic valve replacement so all testing (CT scan, valve and heart pressure measurement, etc) and corrective surgeries performed ( stents in femoral and illiac arteries, stent in coronary artery) and both cardiologist and cardiac surgeon approve of procedure but are stymied by valve replacement coordinator (valve mfg representative) not approving the patient. What would be a next logical step for said patient?