By Adam Pick on November 8, 2018
I received a ton of GREAT questions for our recent Ask Adam Anything: Facebook LIVE Sessions at the Heart Valve Summit. One of the questions that I didn’t have time to answer came in from Shripad who asked, “Hi Adam – In the transcatheter aortic valve replacement procedure (TAVR), what happens to the debris of the old diseased aortic valve which is crushed by the balloon catheter? If the debris cannot be removed, can tiny particles of the debris cause stroke or heart attack? Thanks!”
Before answering Shripad’s question, I thought it would be helpful to show how a TAVR is implanted. As you can see in this video animation, a TAVR device is positioned inside a stenotic aortic valve and then expanded using a balloon. During that expansion, the new aortic valve essentially “smushes” the old valve out of the way. That is why Shripad’s question is so interesting. What happens to the defective leaflets and/or calcium deposits that caused the aortic valve disease?
Dr. Craig Smith Says…
Now that we understand how a TAVR works and why aortic valve debris may occur, let’s answer this very important question.
By Adam Pick on May 31, 2018
Timing heart valve surgery can be tricky for cardiologists, for surgeons and, ultimately, for patients. For this reason, doctors and medical device companies are working together to develop next-generation technologies to determine the right time to operate or to continue “watchful waiting”.
I wanted to learn more about this topic, so I met with John Pascarella from Frankfort, Illinois. John was unexpectedly diagnosed with severe aortic stenosis, a bicuspid aortic valve and an aortic aneurysm during a Medicare physical. Interestingly, John was not rushed into surgery. Instead, Dr. Chris Malaisrie, a leading cardiac surgeon at Northwestern Medicine, used Four Dimensional Magnetic Resonance Imaging (4D-MRI) to watch John closely until surgery was needed. This is John’s story…
By Adam Pick on April 5, 2018
An unexpected gift just occurred in my life.
While on Spring Break with my family in Cabo San Lucas, Mexico, I had the extraordinary pleasure of meeting… Not one… Not two… But, three heart valve patients. Here’s what happened:
First, I met Mike from New Jersey. Mike is a heart valve replacement patient who suffered from aortic stenosis. Like so many patients in our community, Mike was mis-diagnosed several times. It wasn’t until he was severely symptomatic and the valve was almost completely closed that Mike got help.
By Adam Pick on November 7, 2017
Together, we’ve learned lots about the advantages of mitral valve repair procedures which include long-term durability and freedom from re-operation. In the process, I’ve attended wonderful mitral valve conferences and I’ve even gone inside live surgeon workshops dedicated to teaching best practices for mitral valve repair.
That said, you might be wondering, “What about aortic valve repair?” and “Why don’t I hear much about aortic valve repair?”. Unfortunately, our educational efforts specific to aortic valve repair have been minimal. In the past, I simply haven’t received many patient questions about aortic valve repair.
Well… It appears that is about to change. During the recent Heart Valve Summit, I sat down with Dr. Vinay Badhwar, the Professor and Executive Chair of Cardiovascular and Thoracic Surgery at West Virginia University Medicine, to get the latest updates on new aortic valve repair devices and techniques. Here are the exciting highlights from our discussion.
By Adam Pick on October 24, 2017
Aortic stenosis is a wildly misunderstood form of heart disease that impacts 12% of the elderly population. The disease is often mis-diagnosed and often under-treated. This narrowing of the aortic valve is commonly referred to as an “insidious” disease considering (i) its symptoms are regularly and incorrectly discounted to normal aging processes and (ii) patients can be asymptomatic. As the disease can have fatal implications, I’ve also heard several doctors call aortic stenosis a “silent killer”.
As my personal mission is to educate and empower our patient community, I wanted to learn more about aortic stenosis progression. Specifically, I wanted to dig deeper because so many aortic stenosis patients in our community are in “watchful waiting”. In watchful waiting, the patient has been diagnosed with aortic stenosis. However, the severity of the disease does not yet require surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR). So you know… I was in the “watchful waiting” for 7 years.