Percutaneous Aortic Valve Replacement

PARTNER Trial examines minimally invasive approach to valve replacement

What is percutaneous aortic valve replacement?

Percutaneous aortic valve replacement (PAVR) is a promising new treatment for patients with severe aortic stenosis (narrowing of the aorta) who are not ideal candidates for traditional open heart surgery. Brigham and Women’s Hospital (BWH) is one of 24 hospitals nationwide that are examining the potential of this minimally invasive procedure as part of the PARTNER (Placement of AoRTic TraNscathetER Valve) clinical trial. BWH successfully performed its first PAVR procedure in April of 2009.

How does PAVR work?

The surgeon starts by making a small incision in the upper leg and then inserting a catheter, outfitted with a deflated balloon, in the femoral artery (in the upper leg). The catheter is guided up into the chambers of the heart, where the balloon is inflated to open up the diseased aortic valve. This catheter is removed and a second catheter, outfitted with a synthetic valve crimped around a deflated balloon, is moved into the dilated opening. After positioning the catheter, the surgeon inflates the balloon to expand the new valve and secure it into place.

The entire procedure, performed under local and/or general anesthesia, takes 90 minutes, which is followed by a few days of recovery. Open heart surgery typically takes four to six hours, followed by a two to three month recovery period.

What is the purpose of the PARTNER trial?

The purpose of the study is to determine safety and effectiveness of replacing a diseased aortic valve with a synthetic aortic valve (specifically, the Edwards SAPIEN Transcatheter Heart Valve) in patients for whom open heart surgery would be considered too risky. The standard non-surgical treatments for patients with severe aortic stenosis may temporarily alleviate symptoms, but will not cure the condition permanently. Percutaneous aortic valve replacement, however, could eliminate the condition for as long as the synthetic valve remains viable, which is currently projected to be more than 5 years.

For more information

The lead investigators for the PARTNER trial at BWH are Larry Cohn, MD, Division of Cardiac Surgery and Andrew C. Eisenhauer, MD, Director of Interventional Cardiovascular Medicine.  To set up a candidate evaluation or to get more information about the study, please contact  Andrew Eisenhauer, MD, at aeisenhauer@partners.org or (857) 307-1991, or  Annie Connors, RN, at aconnors5@partners.org or (617) 525-7072.