From the April 2022 issue of HealthCare Business News magazine

Since the approval of the first transcatheter aortic valve replacement (TAVR) device in 2011, the procedure has grown steadily in popularity. We spoke with Dr. Matthew Sherwood, co-director of the structural heart program and cardiac catheterization lab at Inova Heart and Vascular Institute, as well as a member of the American College of Cardiology's Interventional Section Leadership Council, about the adoption of this procedure, and to provide a look at its future.

HCB News: From a big-picture perspective, can you tell us a bit about what TAVR entails, and how it compares to the conventional surgical aortic valve replacement (SAVR) treatments it has largely replaced?
Dr. Matthew Sherwood: Transcatheter aortic valve replacement, or TAVR, is a revolutionary treatment for aortic stenosis. Instead of requiring conventional surgery, which would be open heart surgery, a sternotomy, and a five- to seven-day stay in the hospital with four to six weeks of recovery, transcatheter aortic valve replacement is where you actually placed the valve on a catheter through the femoral artery, up to the heart, and then [implanted the valve]. Instead of taking four to five hours for surgery, the procedure takes about an hour.


Most of our patients go home within one day and only stay one day in the hospital. Some stay two days, and then most people are back on their feet doing normal things, even going to cardiac rehab, within one to two weeks.

HCB News: Have the TAVR devices themselves evolved in meaningful ways over the last several years?
MS: We're currently on our fourth-generation devices from the two major manufacturers, Edwards Lifesciences and Medtronic. Edwards makes the Sapien and Medtronic makes the CoreValve and the Evolut PRO+.

Both valves have gotten significantly better. They're able to be delivered on smaller delivery catheters. Initially, it was between 18 and 22 French, which are large catheters, and now it's actually gotten down to 14-French sizes, which are significantly smaller catheters, and that actually is more inclusive. That means more people can actually have TAVR, whereas before some people were excluded, because their femoral artery and iliac arteries weren't large enough to accommodate the device and the delivery system. So that's one thing that's made a huge difference.

And then the devices themselves have gotten easier to deploy, and they all now have what's called a sealing skirt, [which is] some tissue or fabric at the bottom of the device that helps it to seal in the aortic valve annulus, and that helps it to leak a lot less and helps performance. And so that's considerably better.

April 2022 Magazine

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