GREAT NECK, NY -- Transcatheter Aortic Valve Replacement (TAVR), a recent surgical innovation that has changed the way physicians treat aortic stenosis – a narrowing of the aortic valve that impedes the delivery of blood from the heart to the body – is the latest area of cooperation between East and West.
This summer, a team of two American physicians (a cardiac surgeon and an interventional cardiologist) that included North Shore University Hospital’s (NSUH) Bruce Rutkin, MD, Interventional director of Transcatheter Valve Therapies, visited Japan to teach physicians there how to perform the life-saving procedure. Dr Rutkin was one of four investigators at NSUH for the CoreValve US Pivotal Study.
TAVR is a minimally invasive surgical procedure that replaces the diseased aortic valve without removing the damaged valve by inserting a stent-like prosthesis into the aortic valve’s native position. It is currently performed on patients with multiple co-morbidities who are considered to be at high risk for the traditional surgical replacement.
“Aortic stenosis is so debilitating that it often affects such day-to-day activities as walking short distances or climbing stairs,” Dr. Rutkin said. “It generally affects people older than 70, and occurs when the aortic valve doesn’t open and close properly, usually due to deposits of calcium on the leaflets of the native valve.” The valve’s leaflet motion is impaired, which restricts blood flow from the heart to the rest of the body; pressures within the heart are greatly increased, compounding the risk of developing congestive heart failure. Symptoms include extreme fatigue, chest pain or pressure, shortness of breath, and even fainting, Dr. Rutkin explained.
Medtronic’s CoreValve, a transcatheter aortic valve made of nitinol (a self-expanding metal alloy) with porcine leaflets, received FDA approval in 2014. Dr. Rutkin was part of the Heart Team at the North Shore-LIJ Health System that performed its first procedure in April of 2011. He is one of the first physicians in the U.S. asked to teach/proctor the procedure throughout the United States and in other parts of the world.
During the five-day trip to Japan, Dr. Rutkin provided a series of didactic lectures and hands-on simulator training on TAVR to physicians from several of the largest hospitals in Japan. “It was an eye-opening experience as a whole – being able to not only get a complete exposure to another culture from the perspective of a Japanese physician, but also to be able to teach with advancements of new technology in Japan, as well.” Dr. Rutkin said his trip was successful and has been asked to return in the fall to proctor the procedure when it is being performed for the first time at the centers.