Transcatheter Aortic Valve Replacement now being performed at Excela Westmoreland Hospital

Aortic stenosis is the most common valvular abnormality among adults, with more than 200,000 cases per year across the United States — most often among men over the age of 50. Excela Health now offers minimally invasive aortic heart valve replacement as part of a widening array of advanced procedures available to the residents of Westmoreland County through the system’s Heart and Vascular Center at Excela Health Westmoreland Hospital.

Transcatheter Aortic Valve Replacement (TAVR) is being performed on patients with symptomatic, severe aortic stenosis (narrowing or restriction of blood flow) at low, intermediate or high risk for standard valve replacement surgery. A TAVR typically takes less than an hour to complete, and patients can expect to spend less time in the hospital compared to traditional valve replacement.

Current guidelines from the American Heart Association and American College of Cardiology characterize symptoms of severe aortic stenosis as shortness of breath, angina, fatigue, syncope and palpitations. Without aortic valve replacement, severe aortic stenosis is a life-threatening disease and carries a poor short-term prognosis, with a survival rate as low as 50% within two years of symptom development.

For decades, the previous standard of care has been open-heart surgery for aortic valve replacement. TAVR offers an alternative method for many patients. Utilizing a minimally invasive approach through the skin, the valve is typically implanted through the femoral artery, although other access points may be used. TAVR can be an effective option to improve the quality of life in patients who otherwise have limited choices for the repair of their aortic valve.

Prior to treatment, patients are evaluated within Excela’s Structural Heart Program by a multidisciplinary team that includes cardiothoracic surgeons, interventional cardiologists, cardiovascular imagers, cardiac anesthesiologists and nurse navigators. The team reviews cardiac imaging, coronary angiography and CT scans along with a thorough clinical history in order to make the best clinical decision for each patient.

“Optimal treatment is based on this team approach to assist patients in pursuing therapy that is most appropriate for their aortic stenosis,” said Excela’s Nevin Baker, DO, FACC, FSCAI, who is spearheading TAVR utilization at the system.

TAVR is just the latest in a growing list of sophisticated procedures performed in the newly opened hybrid operating room at Westmoreland Hospital. This state-of-the-art surgical suite allows interventional cardiologists, radiologists and cardiac surgeons to work together in one room to perform traditional diagnostic functions of a cardiac catheterization lab or interventional radiology suit, combined with traditional surgical functions of the operating room. Its real-time intraoperative image guidance systems provide unparalleled imaging capabilities in the operating room itself — before, during and after the procedure. For patients, that can translate into a shorter procedure, less anesthesia, less post-operative recovery time and less risk for complications.

According to Excela CEO John Sphon, the introduction of TAVR and the hybrid operating room is yet another tangible reflection of the system’s commitment to offer patents the convenience of advanced cardiovascular care from an exceptional team of clinicians on a local basis. “We are excited about bringing this sophisticated therapeutic option to the residents of Westmoreland County,” he said. “Excela continues to expand the scope of services and expertise it offers across a spectrum of specialties and in doing so, minimizes the need for patients to travel out of the area to receive quality medical care when it is available close to home.”