December 4, 2019 by John Fernandez
Miami Cardiac & Vascular Institute’s Heart Valve Replacement Program (TAVR) Expands to South Miami Hospital
Miami Cardiac & Vascular Institute, part of Baptist Health South Florida, has been a leader for years in performing a minimally invasive procedure that replaces the heart’s aortic valve in patients who are at high risk for complications from traditional open-heart surgery.
That procedure, known as TAVR (transcatheter aortic valve replacement) is now being performed at South Miami Hospital, where the Institute is expanding its range of cardiovascular procedures. Miami Cardiac & Vascular Institute provides cardiovascular services at several Baptist Health locations throughout South Florida.
“We’re excited to bring TAVR to South Miami Hospital, where our patients can get a full complement of cardiovascular care. We have a number of patients who are eager to get TAVR completed at the hospital they perceive to be their home,” said interventional cardiologist Phillip Erwin, M.D., Ph.D., who will lead the South Miami Hospital TAVR team with cardiothoracic surgeon Lisardo Garcia-Covarrubias, M.D.
The aortic valve is one of four valves that regulate blood flow through the heart. For most patients, having to replace a diseased valve because of a narrowed opening (aortic stenosis) requires the potential ordeal of open-heart surgery, along with its possible complications and weeks, if not months, of recovery.
TAVR is mostly reserved for patients 70 years of age or older. In TAVR, the valve is replaced through a pinhole incision in the groin—and can be done without general anesthesia.
“Open-heart surgery is still an option and for many years it was the gold standard,” explains Dr. Garcia-Covarrubias. “But now there are more options and TAVR is a very good procedure for the right patient, particularly the elderly and those with comorbidities (the presence of two or more chronic diseases or conditions in a patient.). There’s a lot of information out there, but we find that patients and their families are becoming very well informed about TAVR.”
The first TAVR procedures at South Miami Hospital were performed last week, and several patients are booked in the coming weeks.
“Generally, our patients are 70 years of age or older,” said Dr. Erwin. “For example, they include a 70-year -old football coach who’s noticed that he is much more short of breath when he’s trying to keep up with his high school football players and a patient with advanced Parkinson’s disease in her 80s who suffers from shortness of breath. So our patients span the spectrum, but what they have in common is that they have severe symptomatic aortic stenosis that is really interfering with their quality of life.”
Over the coming months, Miami Cardiac & Vascular Institute is poised to increase its TAVR cases with the recent expansion of the procedure to mostly younger patients at lower risk for complications from open-heart surgery.
“For the past decade, TAVR has developed as a safer option for patients at high risk for open-heart surgery,” said Barry T. Katzen, M.D., founder and chief medical executive of Miami Cardiac & Vascular Institute. “After clinical trial data and approval by FDA (U.S. Food and Drug Administration), TAVR is now a less invasive option for lower risk patients as well.”
The FDA approved the expansion of TAVR in August for younger, healthier patients.
“It’s a real paradigm shift in cardiovascular medicine,” says Dr. Erwin, “because it allows people who are sick from their diseased aortic valve to have a procedure done under moderate sedation that takes about an hour and performed in a minimally invasive procedure. They are discharged within two days and return to their normal lives within a week.”