New Hope for Heart Patients: Inova Performs New Aortic Valve Replacement Procedure

Matthew W. Sherwood, MD, is board certified in interventional cardiology, cardiovascular disease and internal medicine. He practices at the Inova Heart and Vascular Institute. Read Dr. Sherwood’s profile.

On Wednesday, September 28, the structural heart disease team performed a novel technique to replace a diseased aortic valve in an 81-year-old man. The new technique, transcaval TAVR (or transcaval transcatheter aortic valve replacement), is offered at only about 30 sites around the world. We’re excited to be the first hospital in northern Virginia to perform this procedure.

Because this patient has other medical issues, including kidney problems and severe peripheral artery disease (narrowing of the arteries), he wasn’t a candidate for existing treatments to repair his faulty heart valve. Until now, we’ve had to tell our patient—and others like him—the only way to perform the procedure may be to go through an incision in his chest. Now we can offer him a new option—and new hope.

Pushing the Limits of TAVR

Our patient suffers from aortic stenosis, a disease that occurs when the heart’s aortic valve stiffens and cannot open or close completely. It’s one of the most common heart valve problems, and the most common one in older adults. Aortic stenosis can cause complications, such as chest pain, shortness of breath and heart failure. Without treatment, patients with the disease might live just one or two years.

Until about 10 years ago, the only way to replace the faulty valve was with open-heart surgery. Then researchers developed TAVR, a minimally invasive technique. With TAVR, we insert a catheter, or tiny tube, into the femoral artery of the thigh and up to the heart. We then insert a replacement valve through that catheter.

Unfortunately, TAVR doesn’t work for everyone. When patients have narrow arteries—often due to peripheral artery disease—we aren’t able to pass the catheter through the femoral artery. In those cases, we may have to create an open incision in the chest to deliver the valve, which prolongs recovery.

Now, we are offering transcaval TAVR. With this technique, we insert the catheter through the femoral vein instead of the femoral artery. Once inside the body, we then cross from the venous system into the arterial system. We can use a larger catheter, allowing us to deliver the replacement valve into the heart.

Sharing Knowledge to Help Our Patients Thrive

Just as we learn from those with more experience, we also aim to share our expertise with others. We’re beginning to develop a program in which we’ll help other institutions learn to perform new heart procedures that we have become experts in.

It’s all part of our goal to provide as many patients as possible with world-class healthcare and the most cutting-edge techniques in heart and vascular surgery.

Inova is a leader in minimally invasive valve repair techniques, and our repair rate is higher than the national average.

The Structural Heart Disease Team at Inova Heart and Vascular Institute includes:

• Interventional Cardiologists:
  • Shahram (Shawn) Yazdani, MD
  • Matthew Sherwood, MD
  • Nadim Geloo, MD
  • Kelly Epps, MD
  • Joseph Kiernan, MD
  • Hamid Taheri, MD
• Cardiothoracic Surgeons:
  • Liam Ryan, MD
  • Eric Sarin, MD
  • Alan Speir, MD

 To learn more, visit the Inova Heart and Vascular Institute.