Surgeon Q&A: “Can TAVR Be Used for a Bicuspid Aortic Valve & Aneurysm?” asks Valerie

Valerie sent me a GREAT question about transcatheter aortic valve replacements (TAVR), bicuspid aortic valves and aortic aneurysms. Valerie asked, “Hi Adam – I have a bicuspid aortic valve and aneurysm.  Is there any work being done using the TAVR method to also fix an aneurysm too? Or, does an aneurysm negate use of TAVR for valve surgery?”

 

SAPIEN 3 TAVR (Edwards Lifesciences)

 

To educate Valerie (and our entire community) about this very important topic, I contacted Dr. Michael Mack. So you know, Dr. Mack is Chairman of The Heart Hospital Baylor Plano, the Medical Director of Cardiovascular Surgery at the Baylor Health Care System and a former President of the Society of Thoracic Surgeons. Specific to TAVR, Dr. Mack was very involved in the PARTNER clinical trials which led to the first FDA approval of the Edwards SAPIEN valve in 2011.

 

Dr. Michael MackDr. Michael Mack – Heart Surgeon

 

Needless to say, Dr. Mack is a valve and TAVR guru. He’s also a super nice guy who has helped many patients from our community. 🙂

 

Dr. Mack Says…

First, Dr. Mack addressed the use of TAVR for patients with bicuspid aortic valves.

The best method now and for the forseeable future is still surgery. TAVR has been used for bicuspid aortic valves (BAV) but are still unproven for that indication. They appear to have more paravalvular leak (leakage around the valve) than in patients who have tricuspid valves.

Next, Dr. Mack discussed the use of TAVR for patients with ascending aortic aneurysms.

Ascending aortic aneurysms which occur in about one fourth of the patients with BAV is yet another unsolved issue. Some research studies are now being done on the use of endografts for patients with acute Type 1 aortic dissection  (a tear of the first part of the aorta where the aneurysm occurs) as well as what is termed “branched grafts”.

In his closing remarks, Dr. Mack offered offered optimism for the future of TAVR specific to bicuspid aortic valve and aneurysm therapy.

I have no doubt that this combination of problems will eventually be solved but for the next few years at least, surgery is still the only realistic option.

Many thanks to Valerie for her thoughtful question about TAVR, bicuspid aortic valves and aneurysms. And, a mighty thanks goes out to Dr. Michael Mack for sharing his clinical experience and research with our community!

Keep on tickin!
Adam

Adam Pick
Written by Adam Pick

Adam Pick is a patient, author of The Patient's Guide To Heart Valve Surgery and the founder of HeartValveSurgery.com.

To learn how Adam has helped millions of people with heart valve disease, watch Adam's video, subscribe to his free newsletter, or visit his Facebook, or Twitter pages.

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