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Low-risk patients benefit from minimally invasive transcatheter aortic valve replacement

March 17, 2019

CHICAGO -- Patients suffering from severe aortic stenosis once had a single option for treatment --open-heart surgery to replace their diseased valve.

Results from a New England Journal of Medicine paper, released March 17 and co-authored by S. Chris Malaisrie, MD, cardiac surgeon at Northwestern Medicine and co-chair of the PARTNER 3 case review board, demonstrated that patients who were at low-risk for surgical complications benefited significantly from a minimally invasive, transcatheter aortic valve replacement (TAVR).

"The results of this study are poised to revolutionize the treatment protocol for low-risk patients with severe aortic stenosis, leading to shorter recovery times, lower complication rates and sustained durability of the replacement valve," said Dr. Malaisrie, who is an associate professor of surgery (cardiac surgery) at Northwestern University Feinberg School of Medicine. "Surgeons and interventional cardiologists worked together at Northwestern to rigorously study this novel procedure. We are excited to be part of what truly is a game-changer in the fight against cardiovascular disease."

Northwestern was one of the top 10 enrollment sites for PARTNER 3 in the United States.

The first low-risk TAVR patient in Illinois received the device at Northwestern Memorial Hospital as part of the trial in 2016.

Previously, TAVR was only offered to high-risk or intermediate-risk patients for open-heart surgery. The results are expected to expand TAVR as an option for patients who are at low risk for surgical aortic valve replacement, allowing them to reap the benefits of valve replacement without undergoing surgery.

In TAVR, cardiologists thread the new valve to the heart via a catheter, or tube, inserted in the patient's groin or a small incision under the patient's ribs. In a Cardiac Catherization Lab, the new valve is steered into the diseased valve. The procedure corrects severe, symptomatic aortic stenosis, which narrows the valve, reducing blood flow and causing the heart to work much harder. This can lead to death and symptoms of extreme fatigue, shortness of breath and chest pain. Results from earlier clinical trials on high- and intermediate-risk TAVR patients show positive outcomes that are comparable to, or in some cases, better than open-heart surgery.

Physicians at Northwestern Medicine's Bluhm Cardiovascular Institute have completed more than 1,100 transcatheter valve replacements.

Patients participating in the PARTNER 3 low-risk TAVR trial were randomly selected to either receive the transcathether valve or to replace the valve through open-heart surgery.

"At Northwestern Medicine Bluhm Cardiovascular Institute, we are at the forefront of developing transcatheter valve therapies that are quickly becoming the preferred treatment for patients," said Charles Davidson, MD, clinical chief of cardiology at Northwestern Memorial Hospital and vice chair for clinical affairs, department of medicine at Feinberg. "The exciting PARTNER 3 results are altering the landscape of treatment and recovery for patients with heart disease."

"Northwestern Medicine physicians were among the first in the country to adopt TAVR, which is now considered one of the great breakthroughs in cardiovascular disease treatment," said Patrick M. McCarthy, MD, executive director of the Bluhm Cardiovascular Institute and chief of cardiac surgery at Northwestern Memorial Hospital. "As one of the top enrolling sites for PARTNER 3 in the country, we are proud to be leaders in innovating treatment options with superior results and easier recoveries for our patients."

PARTNER 3 results were published in the New England Journal of Medicine and presented at the American College of Cardiology conference on March 17, 2019.
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Northwestern Medicine's Bluhm Cardiovascular Institute is one of the top 10 national programs for cardiology and heart surgery, according to U.S. News and World Report, and ranked the top cardiovascular program in Chicago, Illinois and the surrounding states for more than 10 consecutive years. For more information about Northwestern Medicine's top ranked cardiovascular care, go to heart.nm.org or call (312) NM-HEART.

To learn more about clinical trials at the Bluhm Cardiovascular Institute, visit feinberg.northwestern.edu/sites/bcvi-ctu.

For more information about Northwestern Medicine, visit news.nm.org/about-northwestern-medicine.html.

Northwestern Memorial HealthCare

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