Transcatheter Aortic Valve Replacement

Transcatheter aortic valve replacement (TAVR) is a minimally invasive, non-surgical treatment option for patients with severe aortic stenosis, a narrowing of the heart valve that doesn’t allow blood to circulate properly to the body. How is it possible to replace a heart valve without surgery? TAVR and the doctors behind the procedure hold the answer.

TAVR was FDA approved in 2011, but only for high surgical risk patients. The indications have since been expanded to include intermediate and high risk patients, with the potential for low risk patients in the future as well. Today, TAVR is incredibly effective at helping those who have critical aortic stenosis. Advances in technology are changing the way TAVR is done on several levels. At Vital Heart & Vein, triple board certified structural cardiologist Dr. Khaled Imad Khalaf, MD, FACC, FSCAI focuses his expertise on TAVR and helping patients in the greater Houston area who suffer from this progressive disease.

Used to replace the diseased, native aortic valve within the heart, TAVR works by using a carefully guided catheter through designated access points on the body to implant a new bioprosthetic valve and help restore blood flow and improve the patient’s quality of life. “The aortic valve separates the main pumping chamber of the heart called the left ventricle from the aorta which sends blood to your entire body…It’s a remarkable technology, and I feel privileged to have trained in one of the highest volume TAVR centers in the world,” says Dr. Khalaf.

Dr. Khalaf cites TAVR as a “nonsurgical way to replace the aortic valve, meaning it’s all done through the groin. Most patients do not even need to have general anesthesia…it is typically an elective outpatient procedure and patients go home the next day!”

Since its first appearance onto the medical scene, TAVR has made several changes. “We’ve been doing [TAVR] for quite some time now, but the technology keeps improving. For example, the sheath size keeps getting smaller, meaning the actual hole that you have to create in the groin artery is much smaller than before. As we continue to do them, the overall risks involved with the case have decreased dramatically,” says Dr. Khalaf.

When it comes to expanding the use of TAVR on a patient-by-patient basis, Dr. Khalaf says, “Initially, it was only approved for high risk patients…in 2016 the indications expanded to include intermediate risk patients, and in 2019 we’re going to hear about low risk patients, which looks very promising.”

Dr. Khalaf is a proud team member of Vital Heart & Vein, one of the largest multispecialty cardiology groups in the 4th largest city in the US. “I’m able to better serve our patients because as you know, Vital Heart & Vein has clinics all throughout the greater Houston area, so that gives us the opportunity to better serve our patient population.”

“It is my very biased opinion that everyone above a certain age needs to visit with a cardiologist…The point that I’m always trying to hammer home is the heart is such a complex, sensitive organ and there are millions of people who walk around every day with blockages in their heart and blockages in their legs, bad heart valves, and they literally have no idea because the body is so adaptable. Screening for cardiovascular disease is a widely under implemented thing is today’s society. My advice is to seek consultation with a cardiologist, especially if you have risk factors.”

More about Dr. Khaled Imad Khalaf

Dr. Khalaf graduated magna cum laude from the University of St. Thomas in Houston, Texas with a Bachelor of Arts in Biological Sciences and a minor in Philosophy. He attended medical school and completed all of his postdoctoral training in the Texas Medical Center at the University of Texas Medical School in Houston where he served as chief cardiology fellow. He currently serves as medical director for the chest pain evaluation center at Kingwood Medical Center and was recently elected chief of cardiology for Memorial Hermann Northeast Hospital. Dr. Khalaf is triple-board certified in internal medicine, cardiovascular disease and interventional cardiology. He specializes in minimally invasive percutaneous treatment of coronary artery disease, peripheral vascular disease, deep vein thrombosis, pulmonary embolism, varicose veins, and venous reflux.

Outside of work, Dr. Khalaf loves to spend quality time with his friends and family. “Family is everything to me. I have a huge immediate and extended family and the support from them means the world. I have a lovely wife, we have been married for 9 years, and I have two amazing boys that keep us very entertained…my oldest is 7 and my youngest is 4. Watching them grow up has been an absolute blessing.”