Doctor Q&A: What Are The Future Advances In Transcatheter Aortic Valve Replacement (TAVR)?
Written By: Allison DeMajistre, BSN, RN, CCRN
Medical Expert: Brent New, MD, Chief of Cardiac Surgery, Methodist Healthcare
Reviewed By: Adam Pick, Patient Advocate, Author & Website Founder
Published: September 19, 2024
In a little over a decade, the utility of transcatheter aortic valve replacement (TAVR) for the minimally-invasive treatment of severe aortic stenosis has exploded. The number of TAVR therapies has soared from 4,600 in 2012 to over 100,000 cases in 2023, according to reports.
With the transformative progress TAVR has undergone in this short time, it’s no surprise that we received a question about the future of TAVR from Michael, a member of our patient community, who asked, “What advances do you foresee in the TAVR procedure in the next 15 years?” We met with Dr. Brent New at the Annual Meeting of The Society for Thoracic Surgeons to answer Michael’s question. Dr. New is the Chief of Cardiac Surgery at Methodist Healthcare in San Antonio, Texas, and gave some interesting insights into possible TAVR innovations coming in the future.
Key Learnings About Future TAVR Advances
Here are important insights shared by Dr. New during our interview:
- There will likely be more advancements in valves than in the TAVR procedure. “We have excellent valves out right now that are working very well,” said Dr. New. “They’re lasting a long time and so forth.” Dr. New believes, however, that rather than seeing innovations in the TAVR procedure, it’s more likely innovations will be in valve capability and adding more valves over time. “Originally, TAVR started in patients who were older, sicker, weren’t likely to live a long time, maybe couldn’t have heart surgery or weren’t candidates for heart surgery, but now we’re using them in more and more patients,” he said. “We believe it’s safe to do so, but the reality is that all animal tissue valves will eventually fail.” Although it may take a long time for the valve to fail, they are using them in younger patients that are expected to live a long time, and he believes these younger patients will likely need future procedures. In order to avoid this, the goal would be to develop a valve that is the same shape and size and can go inside the original TAVR valve. “They can’t be exactly the same because there are some problems with potentially blocking blood flow to the heart.”
- TAVR patients are getting discharged earlier. New said, “I think the procedure is going to look very similar to what it is now. We keep patients overnight in the hospital, but we’re starting to send some patients home the same day.” According to Dr. New, the trend in earlier discharge will continue, but the real TAVR changes will come with newer valves and different nuances involving their shape.
- TAVR valve refinements also apply to bicuspid aortic valve patients. New said, “We’re doing more and more TAVR in bicuspid patients. One of the self-expanding device valves we have for TAVR has been shown to be very safe and effective in bicuspid patients, at least in the early years, though we don’t have long-term follow-up for this.” Dr. New believes some of the newer valves will be tailored more toward bicuspid valve patients since they are younger and receive replacement valves earlier in life.
Many thanks to Dr. New and the entire team at Methodist Healthcare!
On behalf of our entire HeartValveSurgery.com Community, many thanks to Dr. New for sharing some of the TAVR advancements we can expect to see in the future!
Related Links:
- Medtronic TAVR Procedure: What Should Patients Know?
- TAVR Heart Team Finder
- Clinical Trial Update: 4-Year Results for Low-Risk TAVR Clinical Trial
Keep on tickin!
Adam
Written by Adam Pick
- Patient & Website Founder
Surgeon Spotlight
Dr. Mehta is a leading cardiac surgeon at Northwestern Medicine who specializes in heart valve surgery and aortic root reconstruction.
