Valve Disease

Alabama’s first and foremost Comprehensive Valve Program offers the most advanced treatments for heart valve disease to patients throughout the South. UAB Medicine surgeons perform over 400 surgical valve procedures annually, and our program is recognized for excellence by U.S. News & World Report. For 2018-2019, USNWR ranks UAB’s cardiology and heart surgery program No. 18 nationally, while UAB Hospital is ranked No. 1 in Alabama.

We offer a full range of surgical options for patients with heart valve problems, from minimally invasive and interventional techniques to traditional open surgery, which continues to be the most appropriate approach for certain patients. Our transcatheter aortic valve replacement (TAVR) program uses a Heart Team approach, with experienced surgeons and cardiologists providing the latest treatment options in a highly specialized hybrid operating room. To date, this team has performed nearly 900 TAVR procedures while achieving a risk-adjusted mortality ratio of 0.86, which is better than the 90th percentile (0.88) for national hospital performance, according to the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy (STS/ACC TVT) Registry.

UAB Medicine’s cardiovascular surgery program recently achieved an overall composite quality rating of 3 stars in six out of seven STS surgical procedure categories. Additionally, our cardiovascular surgery participant score consistently exceeds the STS mean participant score in all 7 surgical procedure categories.    

Conditions Treated

The UAB Medicine Comprehensive Valve Program offers procedures and treatment for patients with all forms of heart valve disease, including:

  • Aortic stenosis
  • Aortic insufficiency
  • Aortic root aneurysm
  • Aortic incompetence or regurgitation
  • Tricuspid valve disease
  • Pulmonary valve disease
  • Mitral valve disease
  • Myxomatous degeneration
  • Endocarditis
  • Congenital valve disease

Transcatheter Aortic Valve Replacement (TAVR)

Our cardiologists and heart surgeons performed the first TAVR procedure in Alabama in 2012 and have performed more TAVR procedures than any other hospital in the state. TAVR is indicated for patients with symptomatic valvular heart disease due to severe native calcific aortic stenosis and who are judged by the heart team, including a heart surgeon, to be at intermediate or greater risk (>3%) for an open surgical procedure. While most patients are well-suited for transcatheter valve implant using transfemoral approach (87.1%), UAB Medicine cardiologists and surgeons also offer transaortic (4.5%), transapical (2.8%), transaxillary (5.4%), transcarotid, and transcaval approaches for patients who are unable to undergo a transfemoral approach. Patients who have been told by non-UAB doctors that they need valve surgery can speak to a UAB Medicine valve surgeon for a second opinion.

Additional Services & Treatment Options

  • Aortic and mitral balloon valvuloplasty, used as a bridge to valve replacement surgery or to improve quality of life for patients who are not candidates for major heart surgery.
  • Minimally invasive valve surgery involves smaller incisions than with open heart surgery but larger incisions than with robotic surgery. Typically, minimally invasive valve surgery is recommended when valves need replacement rather than repair, or when the repair is complex. Any of the four heart valves can be reached using some form of minimally invasive surgery.
  • Valve-sparing aortic root replacement is performed for a number of conditions that cause aneurysmal formation in the aortic root. With aortic root disease, valve sparing may present a better option for suitable patients to free them from the complications of prosthetic valves. Root replacement is considered when the maximum diameter of the root reaches 5.0 to 5.5 cm.
  • Periprosthetic valve leak closure is used to treat periprosthetic leaks that have developed around a surgically implanted valve. While this is uncommon, patients affected by this condition are likely to suffer from severe hemolysis or heart failure. Closure of these periprosthetic defects is now feasible using a percutaneous approach in patients with suitable anatomy, allowing for treatment without the need for surgery.
  • Transcatheter valve-in-valve replacement uses percutaneous techniques to place a transcatheter valve in an existing dysfunctional bioprosthetic valve. This treatment is available for patients with aortic bioprosthetic valve dysfunction who are not candidates for reoperation.
  • The transcatheter mitral repair (MitraClip) is performed utilizing a percutaneous technique to repair degenerative mitral valve regurgitation in patients who are deemed to be at prohibitive risk for open surgery.
  • James Davies Jr., MD, director of the UAB Division of Cardiothoracic Surgery, is the first surgeon in the Southeast to implant the new Edwards Inspiris heart valve, which is made of specially treated bovine tissue that may help it last longer and has an expandable frame to allow future valve-in-valve procedures. It is ideal for younger patients who need surgical replacement of their aortic valve. It is built on the same frame as the most trusted tissue valve that has been used for decades. Although initial placement of the valve does require open surgery, its expandable frame makes it more suitable for future percutaneous valve replacement. This means that if the patient needs to have the valve replaced in the future, open surgery is not required again. The valve is a perfect example of how traditional surgical and transcatheter programs can seamlessly work together to provide patients with the highest quality lifelong care.

How to Refer

To refer a patient to the UAB Medicine Comprehensive Valve Program, please call UAB MIST (Medical Information Service via Telephone) at 1-800-UAB-MIST (800-822-6478).

To refer a patient directly to the TAVR program, please call 205-975-1888 or click here to complete our online referral form.

Access Your Patients' UAB Records - UAB Ambassador

UAB Ambassador is a service that allows referring physicians to access their patients’ UAB records – including inpatient and outpatient documents, activities, and lab results – through a secure online portal.

To request access to Ambassador, click here to complete the form and return to UAB Physician Services via fax to 205.996.9107 or via email to physicianservices@uabmc.edu. For more information or questions regarding Ambassador, contact UAB Physician Services at 205.934.6890 or email physicianservices@uabmc.edu.


CARE PROVIDERS

 

Educational Opportunities

The Latest Advances in Treatments for Aortic Stenosis

Mark Sasse — With the first and largest comprehensive heart valve program in the state, UAB Medicine provides continuing care for patients who have or are at risk for valve disease. UAB was the first hospital in the state of Alabama to perform the TAVR procedure, in 2012. More than 300 total cases have been completed since then. Listen in as Mark Sasse, MD explains Aortic stenosis and the progress made in treatments and advances.

Valve Replacement Options: Portico™ Transcatheter Aortic Heart Valve

Mark Sasse — The Portico™ Transcatheter Aortic Heart Valve offers outstanding control and accuracy for optimal patient outcomes with low rates of post-procedure pacemaker implantations, complications and paravalvular leak (PVL). The valve's unique delivery system provides controlled deployment for greater accuracy and precise placement. Listen as Dr. Mark Sasse, MD., Associate Professor in Interventional Cardiology at UAB Medicine discusses valve replacement options.

 

Images and Videos

 

CLINICAL TRIALS

UAB is an active participant in research and clinical trials for the diagnosis and treatment of heart valve disease. We encourage you to speak to your physician about research and clinical trial options and browse the link below for more information on clinical trials at clinicaltrials.gov.

View Clinical Trials
 

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