Surgical aortic valve replacement is extremely low-risk for most patients. However, a significant number of patients are at high-risk for surgical valve replacement or are ineligible for surgery because of comorbidities. The less invasive TAVR procedure allows a new valve to be inserted within the native, diseased aortic valve, and can be performed utilizing multiple approaches (e.g., transfemoral, transapical, or transaortic).¹
Penn State Hershey Heart and Vascular Institute is unusual in its balanced case mix, according to chief of cardiac surgery, Walter E. Pae, Jr., M.D., “Our practice is fairly evenly divided among congenital pediatric heart defects, adult coronary disorders, and adult cardiac valve abnormalities. We perform up to 100 aortic valve replacements per year.” Interventional cardiologist Mark Kozak, M.D., concurs, noting that coronary disease is the focus of many institutions, due to its far greater frequency. Continue reading
Wrist prepped for transradial artery catheterization for PCI.
Transradial artery (TRA) access for percutaneous coronary intervention (PCI) versus transfemoral artery access, is a relatively recent development in medicine, with femoral access often the default for many interventional cardiologists since balloon angioplasties were first performed.1
Ongoing data supports that TRA PCI involves less bleeding risk, a reduced rate of vascular complications, lower costs, and greatly improved patient comfort.1
One study of more than 250 patients demonstrated that forearm access is safer than using the femoral vessels.2 However, the United States has lagged behind Europe, Asia, and other developed regions in the adoption of TRA procedures.1 China uses the technique about 80 percent of the time, and the European Society of Cardiology has recently recommended a “radial first” approach.1 According to Ian Gilchrist, M.D., professor of medicine, Penn State Hershey Heart and Vascular Institute, the United States currently averages a 30 percent rate of TRA coronary intervention procedures per year.