McLaren Flint Structural Heart Specialists Help Sickest Patients with Valve Replacement Options

Author: Sherry Farney

Heart patients in and around Genesee County can now benefit from another minimally invasive valve replacement procedure available at McLaren Flint.

The hospital’s structural heart team recently performed a carotid transcatheter aortic valve replacement (TAVR). The aortic valve is one of the heart’s four valves and its main role is to keep oxygen-rich blood from flowing back into the left ventricle. When the valve begins to fail blood can back up in other chambers of the heart and even into the lungs. The heart also begins to work harder and if left untreated it can lead to heart failure.

When patients have serious and complex health conditions, their surgical options become limited including not being eligible for open-heart procedures that involve cutting through the chest and breast bone and replacing the aortic valve. This is when minimally invasive TAVR options come into play.

The usual access site for delivering the TAVR is through the femoral artery in the groin. Some patients have such advanced cardiovascular disease that the groin arteries are also very narrow and calcified making this approach unfeasible for TAVR. In this situation, doctors look at other arteries in the body to deliver the valve replacement such as the arteries in the arm and neck.

Carotid TAVR can be a treatment option for patients who do not qualify for a groin or arm approach.

The carotid artery is located in the neck and is a vital blood vessel in the body as it provides blood and oxygen from the heart up to the brain. The carotid TAVR approach takes highly trained physicians to perform it.

“Where the catheters are inserted into the body to deliver the new heart valve up through to the heart, is dependent upon how narrow and calcified the patient’s arteries are in their legs and arms,” said Ahmad Munir, MD, board-certified interventional cardiologist, and director of structural heart disease at McLaren Flint. “Imaging is very important in helping us to see how diseased and narrow a patient’s arteries are and whether there is a TAVR option for them.” Each patient’s case is discussed by cardiology, cardiothoracic surgery, and structural heart clinicians during multi-disciplinary valve clinics. The team decides what option is the best one for each individual.

“The carotid approach is an acceptable alternative approach for TAVR cases,” said James Martin, MD, a board-certified cardiovascular surgeon who is a member of the heart valve team at McLaren Flint. “This approach can help very sick patients and we are pleased to be able to offer it to patients right here in Genesee County and surrounding communities so they do not have to travel far to get the specialized heart care they need.” Before, during, and after the carotid TAVR procedure, it was all hands on deck. The heart valve team received additional education on the technique and reconfiguration of the hybrid operating room. This is a specialized operating room where TAVR procedures are performed and can accommodate both minimally invasive and open-heart procedures.

“It’s exciting to see everyone come together so we can provide the most up-to-date minimally invasive options to patients, and keep them close to home, whether they are low, intermediate, or high-risk,” said Dr. Munir.

In addition to the TAVR procedures, the structural heart team also performs mitral valve repair (MitraClip), intravascular lithotripsy, and placement of devices including the Impella and Watchman. To learn more about all of the comprehensive heart procedures offered at McLaren flint visit,