TAVR for aortic stenosis spurs surgical improvements



SNOWMASS, COLO. – Surgical aortic valve replacement is a mature operation with durable outcomes, but surgeons aren’t standing still in the face of competition posed by cardiologists’ transcatheter alternative.

Well along in clinical development is a minimally invasive surgical aortic valve replacement (SAVR), which utilizes a novel hybrid valve deployed via a 10-second balloon inflation, thereby avoiding the time-consuming suturing and knot-tying required when traditional surgical valves are sewn into place. This minimally invasive procedure involves a partial sternotomy so as to better maintain the skeletal integrity of the sternum, Dr. Michael J. Mack explained at the annual cardiovascular conference at Snowmass sponsored by the American College of Cardiology.

Dr. Michael J. Mack

"I think this has the potential to cut surgical times in half. Indeed, the operations are now taking a total time of about 1 hour 45 minutes. This makes SAVR a better option for elderly patients who may not be TAVR candidates," said Dr. Mack, medical director of cardiovascular surgery for the Baylor Health Care System and director of cardiovascular research at the Heart Hospital in Plano, Tex.

A major clinical trial of the innovative hybrid no-suture valve, called the Edwards Lifesciences Intuity Valve System, has been completed in Europe, and another is underway in the United States. Other major medical device companies are also developing no-stitch surgical aortic valves.

"Now we can make SAVR better because there’s a less-invasive option. This never would have happened in surgery unless TAVR happened," Dr. Mack observed.

He reported receiving research grants from Edwards Lifesciences.

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