Aortic valve replacement in patients with inadequate arterial access

2017

Challenge

Narrowing of the heart’s aortic valve, known as aortic valve stenosis, is the most common heart valve disease in elderly patients. Diseased peripheral arteries can result in reduced access to the heart, forcing surgeons to resort to more invasive open-heart surgery to replace the valve, a procedure that is often considered too high-risk for elderly patients to endure.

Advance

IRP researchers led by Robert J. Lederman, M.D., discovered that the heart could be accessed via a vein instead of through diseased arteries. In a study involving 100 patients, this innovative technique was found to be a successful alternate route for heart valve replacement. 

Impact

Dr. Lederman’s approach provides a viable alternative for accessing the heart in patients requiring aortic valve replacement, thereby expanding access to patients with peripheral artery disease who otherwise might have no good options. 

Publications

Greenbaum AB, Babaliaros VC, Chen MY, Stine AM, Rogers T, O'Neill WW, Paone G, Thourani VH, Muhammad KI, Leonardi RA, Ramee S, Troendle JF, Lederman RJ. Transcaval Access and Closure for Transcatheter Aortic Valve Replacement: A Prospective Investigation. (2017). J Am Coll Cardiol. 69(5):511-521.