Repairing Heart Valves without Opening Chests

The Roper St. Francis TAVR Team

For older patients, open heart surgery can be risky and require extended stays in the hospital.

A new, advanced procedure offered at Roper Hospital reduces these patients’ recovery time and will help them live longer, healthier lives.

The procedure is called transcatheter aortic valve replacement or TAVR. It’s a catheter-based procedure that replaces the heart’s valve instead of repairing it. Unlike a typical valve replacement, TAVR doesn’t require a patient’s chest to be opened. Surgeons can move the replacement valve through an artery that can be inserted in areas near the chest or the groin, depending on the patient’s body and health.

“This puts us on the cutting edge of surgery,” said Dr. Michael Grayson, director of heart and vascular services at Roper St. Francis. “It is the newest and most complicated procedure that we do.”

No more than five hospitals in South Carolina are performing this kind of surgery, and Roper Hospital is the second in the Lowcountry to offer TAVR. Roper Hospital Chief Executive Officer Matt Severance said he’s proud of the TAVR team, which has done an exceptional job bringing the latest in cardiovascular care to our patients.

“As the nation’s sixth oldest hospital, Roper has a 150-plus year tradition of offering high-quality care to our community,” Severance said. “The ability to offer our patients TAVR, the latest, minimally invasive procedure available, is another opportunity for us to continue that legacy of service and excellence.”

Roper Hospital has been studying, training and preparing for TAVR for the past two years, and it has approval from the Centers for Medicare and Medicaid Services to perform the surgery. The hospital started screening patients seven months ago to identify potential candidates for the surgery; only a small percentage will qualify for it. The hospital began doing TAVR surgeries in early December.

A team of nearly two dozen hospital staff, including a cardiothoracic surgeon, cardiologists and anesthesiologist, are in the operating room for the TAVR procedure because it’s a multi-specialty technique. To better accommodate the team needed for these surgeries, Roper Hospital plans to build an operating room that will be about twice the size of what exists now.

TAVR is designed to open the aortic valve, through which blood is pumped to the rest of the body. As time passes, the aortic valve tends to calcify and constrict, so a replacement valve is needed to make that passageway larger. With TAVR, a bio-prosthetic valve mounted in a cobalt-chromium stent, or what looks like a thumb-size, crown, is inserted into the aortic valve and opened.

Patients who have TAVR have a slightly shorter recovery time than those who have open-heart surgery, but the primary benefit of TAVR is that it carries far less risk. The average age of TAVR patients is 83.

“TAVR gives our patients the opportunity to have a better quality of life,” Grayson said.