Kenneth Shelton, MD, is a critical care physician and cardiothoracic anesthesiologist in the Department of Anesthesia, Critical Care and Pain Medicine at Massachusetts General Hospital and the medical director of the Mass General Corrigan Minehan Heart Center Intensive Care Unit.
Transcatheter aortic valve replacement (also known as TAVR or TAVI) is a minimally invasive procedure used by physicians at the Massachusetts General Hospital Corrigan Minhean Heart Center to treat patients with aortic valve stenosis.
Patients who have severe aortic stenosis (a narrowing of the valve that restricts blood flow) and are considered high risk or non-operable for open-heart surgery may be candidates for the transcatheter aortic valve replacement (also known as TAVR or TAVI) procedure.
About The Procedure
During this procedure, physicians use minimally invasive techniques to implant a new heart valve without open-heart surgery. Physicians use a transfemoral (from the leg), transaxillary (from the shoulder), or transapical (through the chest) approach, by inserting a transcatheter heart valve that is mounted and crimped onto a balloon delivery catheter. It is then threaded through the patient’s circulatory system and directly into the heart’s pumping chamber.
Upon reaching the site of the patient’s diseased heart valve, the balloon expands, and the transcatheter heart valve is deployed across the patient’s diseased valve. This procedure is performed on a beating heart, meaning that there is no need for a cardiopulmonary bypass and its associated risks.
Transcatheter aortic valve replacement has been proven to have superior safety and efficacy and is currently approved by the US Food and Drug Administration for patients with aortic valve stenosis that are at high or extreme risk for open-heart surgery. Healthier patients may have an opportunity to receive transcatheter aortic valve replacement through one of our ongoing clinical studies.
Ongoing Clinical Trials
- The PARTNER II Trial: Placement of AoRTic TraNscathetER Valves
- Portico Re-sheathable Transcatheter Aortic Valve System US IDE Trial
Our multidisciplinary care team includes cardiac surgeons, interventional cardiologists, noninvasive cardiologists, cardiac anesthesiologists, cardiac imaging specialists, nurse practitioners, registered nurses and technicians with robust experience in the evaluation and treatment of patients with valvular heart disease. Patients referred to us undergo a thorough evaluation in order to determine the treatment option that would be best for the patient. Specifically, all patients being considered for TAVR will receive:
- Cardiac catheterization
- Transthoracic echocardiogram
- Cardiac computed tomography scan (CAT scan)
- Pulmonary function testing
- Carotid artery ultrasound
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