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TAVR Provides Relief for Hearts When the aor tic valve in the hear t narrows—a condition called aor tic valve stenosis— it causes the hear t to work harder to pump blood through the body. Open-hear t surger y is usually recommended to treat the condition, but some patients are not candidates for this procedure. A minimally invasive but highly advanced procedure that ver y few hospitals are equipped to provide, known as transcatheter aor tic valve replacement ( TAVR), can be used to address the problem when open-hear t surger y is not an option. Take this quiz to gauge how much you know about TAVR and gain insight on the topic from Terrence Sacchi, M.D., chief of cardiology at NewYork-Presby terian Brooklyn Methodist Hospital. What are some of the causes of aortic valve stenosis? a. Calcium buildup on the aortic valve b. Congenital heart defect c. Rheumatic fever d. All of the above Answer: d. All of these conditions have the capacity to narrow the aortic valve and interfere with the heart's ability to pump blood. What symptoms indicate severe aortic valve stenosis that a cardiologist might manage through TAVR? a. Chest pain b. Fainting c. Shortness of breath d. All of the above Answer: d. As the aortic valve narrows, individuals living with severe aortic valve stenosis may experience a variety of symptoms, including those listed above, as well as heart palpitations and fatigue. "When those symptoms begin to emerge, a patient's quality of life begins to decrease because of recurring chest pains, shortness of breath, fainting spells or even heart failure, but TAVR can help offer relief," Dr. Sacchi says. Which patients should consider TAVR? a. Someone with mild aortic valve stenosis b. An individual with moderate valve stenosis c. A person with severe aortic stenosis who is not a candidate for open-heart surgery d. All of the above Answer: c. "Many patients, particularly those growing older and living with conditions like lung disease or diabetes, are not typically offered surgical aortic valve replacement," says Dr. Sacchi. "TAVR is a noninvasive way to replace the valve in such patients and manage severe aortic stenosis." The TAVR procedure involves ___________ replacement of the dysfunctional aortic valve (fill in the blank). a. Complete b. Partial Answer: a. "TAVR is a minimally invasive procedure that allows us to completely replace the damaged valve," Dr. Sacchi says. "A new valve implanted on a balloon catheter is passed through an artery in the leg and is placed within the old valve. The balloon is inflated, and the new valve is implanted. Much of the work to develop and utilize this procedure was done by physicians in the NewYork-Presbyterian system." True or false: A cardiac surgeon performs the TAVR procedure. Answer: True. An entire team, including interventional cardiologists, cardiologists and staffs from the cardiac catheterization lab and intensive care unit, all collaborate with a cardiac surgeon to perform this procedure. P H Y S I C I A N RE F E R R A L / / 718 . 49 9. C A RE 29 H E A LT H Q U I Z