New option for heart valve replacement

Approximately 5 million Americans are diagnosed with heart valve disease each year. According to the American Heart Association, with an aging population that is often too frail for open-heart surgery, more than 20,000 Americans die from the disease each year.

Transcatheter aortic valve replacement (TAVR) is a minimally invasive alternative to open-heart surga

For patients whose anatomy prevents femoral artery access, a transcaval access route offers a new option by temporarily connecting major blood vessels in the abdomen.

The first successful transcaval valve replacement on the West Coast was performed by cardiologist Dr. Maurice Buchbinder at Sharp Chula Vista Medical Center on Oct. 10.

During transcaval valve replacement, a wire is guided into the leg and through the femoral vein. The cardiologist enters through the vein and a parallel artery in the abdomen. Through careful access with openings between the vena cava (larger vein) and the aorta, a catheter is placed as a bridge, allowing access that would not be possible using the traditional route.

A smaller catheter is moved through the vein, across the bridge and through the artery into the heart to implant the transcatheter aortic heart valve. After the valve is implanted, the artificial bridge is removed and a plug is deployed, closing the holes to allow the blood vessels to function normally.

According to estimates, 25,000 to 50,000 patients in the United States could be helped by this option each year, when scar tissue, atherosclerosis, small arteries or other issues prevent traditional heart access.

Dr. Buchbinder performed the procedure on a female patient for whom traditional surgical or transfemoral valve replacement was not an option.

“We’re excited to offer some of the most advanced cardiology procedures in the world at Sharp Chula Vista Medical Center,” says Dr. Buchbinder. “We’re pleased that the procedures we perform here can help patients throughout San Diego and across the country.”