TAVR (Transcatheter Aortic Valve Replacement)
St. Tammany Health System is the first Northshore health system to offer minimally invasive valve replacement, TAVR, close to home in Covington. TAVR is less invasive than open-heart surgery.
TAVR does not require the chest to be opened, only small incisions similar to angioplasty (threading a catheter to unblock heart arteries). The TAVR heart valve is made from pig heart tissue and a blend of nickel and titanium mesh designed to function like the human valve it is replacing. In the procedure, the cardiologist threads a catheter through the arteries from a small incision in the groin, neck or a space between the ribs to place the mesh valve where the diseased valve exists. The entire procedure typically takes an hour or two, and patients typically go home in one day.
“This is a program, not a procedure,” explained Shannon Holley, STHS department head of cardiovascular services. “TAVR is the procedure, but we have developed an entire program with a care coordinator and heart team that follow our patients leading into the TAVR, during the procedure to post-procedure recovery and follow-up. We are committed to delivering the safest, most innovative advances in cardiac care here at St. Tammany.”
The STHS TAVR program begins with Karolina Ruthner APRN, nurse practitioner and valve program coordinator. She helps patients navigate the experience before, during and after the procedure.
“We work with the cardiologists and surgeons to determine the best patients for this procedure,” explained Ruthner, “and we follow each patient’s case through a series of tests and diagnostics that determine the best care plan. Then through the procedure and onto recovery and beyond.”
Once the patient is established to be a TAVR candidate, Ruthner arranges the heart team, including interventional cardiologist, cardiovascular surgeon and support team including nurses and technologists from the cath lab, along with the surgical team and anesthesia professionals to ensure both the minimally invasive and the open procedure are prepped and available.
“Any TAVR case has some risk for needing to become an open case,” explained Holley. “As part of our program, we have set up a cath lab with the equipment and personnel we need to perform the TAVR or to switch to an open heart surgery should that become necessary.”
Dr. Hamid Salam from Covington Cardiovascular Clinic at STHS and Dr. George Isa from Ochsner Health System are the TAVR interventional cardiologists, and they collaborate with Ochsner cardiothoracic surgeons Dr. Jose Mena, Dr. Greg Eckholdt and Dr. Charles Dicorte and LA Heart’s Dr. Louis Hebert. Together, the cardiologist and surgeon determine the best way forward for each case and then perform the procedure together.
Learn more about TAVR at these links:
American Heart Association, What is TAVR?
Medtronic TAVR heart valve