Valve-sparing aortic root repair
Operations designed to spare the aortic valve are of two types: remodeling of the aortic root and re-implantation of the aortic valve. These operations are designed to preserve a patient’s original aortic valve while the patient undergoes surgery for an aortic root aneurysm or ascending aortic aneurysm. Re-implantation of the aortic valve has a lower risk of developing aortic insufficiency, but should be used on younger patients who may have the type of inherited disorders that cause aortic root aneurysms. For older patients with ascending aortic aneurysm, it is safer to remodel the aortic root.
Transcatheter aortic valve replacement (TAVR) is a minimally invasive cardiac surgical procedure performed on high-risk patients suffering from severe aortic stenosis, which is a narrowing of the aortic valve. Northwell was one of the first health systems in the region to offer the TAVR heart valve procedure.
During TAVR, the cardiac surgeon guides a catheter, with an artificial aortic valve attached, through an artery to the heart, without splitting the breastbone. The procedure is done through a small puncture in the femoral artery of the leg or a small incision in the side of the chest between the ribs. Using state-of-the-art imaging, the surgeon checks the valve for proper placement. The valve expands and is anchored inside the aorta, restoring blood flow. For patients who require aortic valve replacement and are considered good candidates, minimally invasive techniques also include partial sternotomy.
Patients with severe aortic stenosis are often elderly and have other medical conditions that make it too risky to perform open-heart surgery. These patients, who previously had few or no treatment options, are now considered for minimally invasive valve replacement.