Watch Deepak Talreja, M.D., treat a patient with congested heart failure due to severe narrowing of their aortic valve, by performing a Transcatheter Aortic Valve Replacement (TAVR).
Hi, my name is Deepa. I'm a cardiologist with Sentra cardiology specialists in Hampton Roads, Virginia. I'm one of the leaders of our structural heart and valve center team. And today I'd like to share a case with you of a transcatheter based aortic valve implant, what we call Taber transcatheter based aortic valve implant. This is a patient who presented us to, to us with severe symptoms of congestive heart failure. She had symptoms of shortness of breath of low extremity, swelling and low quality of life with limited abilities to perform her daily activities. We did a heart ultrasound and what that demonstrated is that she had a severe narrowing of one of the four heart valves. The aortic valve that valve can be corrected either with a surgical replacement or with a catheter based replacement. And ultimately, after our team, both our surgeons and our cardiologist examined her carefully, looked at all the scans we put together, we felt she would be best served by a transcatheter based aortic valve replacement. And that's what you'll see in this video coming up on the screen. You see us in the hybrid operating room at heart hospital. You see me, our physicians, assistant, Sarah Kennedy and anesthesiologist, Sarah Witt, we're starting by obtaining large sheath access, which we do on a under ultrasound. And then we place our large sheet of 14 French sheath in the artery side that we're putting our valve in. In this patient with severe aortic valve stenosis, we watch the valve sheath go into place and then through that sheath. After we've got it in place, we advance catheters to measure the gradient across the or valve. Here we are crossing the aortic valve and positioning one catheter inside the left ventricle and one inside the aorta. We can see the severe aortic stenosis on the hemodynamic screens on the bottom. And now we've positioned a stiff wire across the aortic valve into the left ventricle and we're advancing this Taber valve. This is the volute FX platform we're using. Here. We have a wide variety of platforms that we use in this procedure. We've advanced it around the aortic valve. And now surgeon Doctor Clint Kemp has joined us. You see the pacemaker being adjusted and our cat lab teams and or teams are very active as we deploy the valve into position. Now, we've got the valve inserted in the old valve and we're releasing it into place and we immediately have a functioning valve on the screen. Our team now carefully analyzes the valve to make sure as you see on that last picture that there's no leakage through the valve we'll use a combination of x-ray and ultrasound to verify that the position is perfect and to look for any signs of leakage, any evidence of injury to the heart or other problems. And in this case, the result is really just perfect. This is exactly what we look for with a functioning ta or valve.
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