Allegheny Health Network Specialists Perform Pittsburgh Region’s First Procedure with Next-Generation Heart Valve Replacement Device

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In their continued efforts to provide the region’s most innovative cardiovascular care, Allegheny Health Network cardiac specialists recently implanted the newest generation of a Transcatheter Aortic Valve Replacement (TAVR) device in a patient with aortic valve stenosis. Allegheny General Hospital (AGH) is the first medical center in western Pennsylvania to perform the SAPIEN 3 Transcatheter Heart Valve (THV) procedure, which provides an alternative treatment for patients with aortic valve stenosis who are unable to undergo open heart surgery.

Allegheny General Hospital

This new transcatheter valve provides a wonderful alternative for patients whose medical comorbidities put them at high risk for open heart surgery.

In their continued efforts to provide the region’s most innovative cardiovascular care, Allegheny Health Network cardiac specialists recently implanted the newest generation of a Transcatheter Aortic Valve Replacement (TAVR) device in a patient with aortic valve stenosis. Allegheny General Hospital (AGH) is the first medical center in western Pennsylvania to perform the Edwards SAPIEN 3 Transcatheter Heart Valve (THV) procedure, which provides an alternative treatment for patients with aortic valve stenosis who are unable to undergo open heart surgery.

In June, the U.S. Food and Drug Administration (FDA) approved the third generation of the SAPIEN THV, which the FDA originally approved in 2011. Allegheny Health Network has performed more than 350 of the potentially life-saving TAVR procedures at AGH and Saint Vincent Hospital.

Stephen Bailey, MD, Director of Cardiac Surgery at AGH, and David Lasorda, DO, Director of Interventional Cardiology at AGH, implanted the valve through the patient’s femoral artery. “The SAPIEN 3 THV features a major design change to minimize leakage around the valve,” said Dr. Lasorda. “A skirt has been added to the base of the valve to minimize leakage, and the delivery system has been miniaturized, which fosters better outcomes for these patients.”

Aortic stenosis – a severe narrowing of the aortic valve of the heart – forces the heart to work harder to push blood through the damaged aortic valve, eventually weakening the heart muscle. Aortic stenosis can cause fainting, chest pain, heart failure, irregular heart rhythms (arrhythmias) and cardiac arrest.

In the clinical trial, patients with SAPIEN 3 had a significantly lower rate of leakage around the valve (3.0 percent at 30 days) compared to patients treated with the previous generation of SAPIEN (14.3 percent at 30 days). The FDA approved the SAPIEN 3 THV after that clinical study of nearly 600 patients with aortic stenosis who were at high risk for open heart surgery.

“The SAPIEN 3 was also found to have very low rates of stroke and vascular complications,” said Dr. Bailey. “This new transcatheter valve provides a wonderful alternative for patients whose medical comorbidities put them at high risk for open heart surgery.”

TAVR is a less invasive treatment for heart valve disease that involves replacing the damaged aortic valve with a new one while the heart continues to beat on its own. AGH’s multidisciplinary team does a comprehensive evaluation of patients to identify the optimal procedure for each individual patient. That team includes cardiac surgeon Robert Moraca, MD, and interventional cardiologist Ramzi Khalil, MD, as well as cardiac imaging specialists and cardiac anesthesiologists.

“TAVR is just one of several leading-edge procedures Allegheny Health Network has started performing in recent years in order to provide the best possible care for patients with diseased or damaged heart valves,” said Srinivas Murali, MD, Director of Allegheny Health Network's Cardiovascular Institute.

For example, AGH is among a select group of medical centers nationwide to perform a robotically assisted mitral valve repair surgery, which reduces trauma to tissue and muscles by accessing the valve with a few small incisions on the side of the chest. AGH also began offering MitraClip therapy in 2014, a novel, catheter-based approach that allows interventional cardiologists to use fluoroscopic guidance to insert a clip through the groin to the impacted area along the mitral valve.

“By providing our patients a variety of minimally invasive procedures to treat heart valve problems,” Dr. Murali added, “Allegheny Health Network continues to lead the way in cardiovascular care in western Pennsylvania.”

About Allegheny Health Network
Allegheny Health Network, part of Highmark Health, is an integrated healthcare delivery system serving the Western Pennsylvania region. The Network is comprised of eight hospitals, including its flagship academic medical center Allegheny General Hospital, Allegheny Valley Hospital, Canonsburg Hospital, Forbes Hospital, Jefferson Hospital, Saint Vincent Hospital, Westfield Memorial Hospital and West Penn Hospital; a research institute; Health + Wellness Pavilions; an employed physician organization, home and community based health services and a group purchasing organization. The Network employs approximately 17,500 people and has more than 2,100 physicians on its medical staff. The Network also serves as a clinical campus for Temple University School of Medicine, Drexel University College of Medicine and the Lake Erie College of Osteopathic Medicine.

About the AGH Cardiovascular Institute
Allegheny General Hospital, the quaternary flagship of Allegheny Health Network’s Cardiovascular Institute, offers comprehensive, state-of-the-art care for the complete spectrum of cardiovascular disease. The hospital’s nationally recognized medical staff includes specialists in general and interventional cardiology, electrophysiology, leading-edge diagnostic cardiology – including cardiovascular MRI, CT and 3-D echocardiography – women’s heart care, heart failure and pulmonary hypertension, heart transplantation and mechanical circulatory support, vascular surgery and wound care, thoracic surgery, heart valve disease and coronary artery bypass surgery. AGH is recognized by leading healthcare industry analyst Comparion as western Pennsylvania’s top hospital in quality and safety for overall cardiovascular care and complex heart surgery.

AGH’s broad scope of advanced capabilities in the treatment of heart failure offers patients access to cutting-edge investigational therapies being explored in clinical trials, such as new medicines and implantable devices designed to more effectively monitor disease progression and treat conditions before they require hospitalization. The hospital was recently the first in western Pennsylvania to use the latest-generation total artificial heart to provide a bridge to transplantation for patients with end-stage heart failure. It also has become one of just a few national referral centers for advanced treatment of pulmonary hypertension. AGH’s heart transplant program is lauded by both Comparion and the National Scientific Registry of Transplant Recipients as having the best patient outcomes of any program in the region.

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Doug Braunsdorf
Allegheny Health Network
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