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University of Florida/Ray Carson

Physicians performed UNC Hospitals’ first Transcatheter Aortic Valve Replacement procedure in November 2014. In 2016, the number of TAVR cases may be triple the number performed in 2015. Much of that increase can be attributed to good patient outcomes, coupled with the program’s effort to establish relationships with cardiologists across North Carolina, say cardiac surgeon Thomas Caranasos and cardiologist John Vavalle, who are directors of UNC’s TAVR program.

TAVR provides a treatment option for aortic valve replacement for many patients who are not good candidates for conventional open-heart surgery or are too frail to undergo surgery. A surgeon and a cardiologist provide aortic valve replacement via minimally invasive approaches, providing outcomes that are as good as traditional surgical valve replacements and sometimes have better outcomes than traditional surgery.

The UNC program has introduced innovations to help provide TAVR to patients who may not have been eligible for the procedure before. One advance is the suprasternal TAVR approach, which avoids running a catheter through the groin (typical of most TAVR procedures) and instead threads it directly into the chest. The team has also participated in the roll-out of a next-generation valve that can be repositioned, helping to ensure proper placement.