b'12 2021 I N N O V A T I V E T E C H N O L O G Y A N D P R O C E D U R E S | E X P E R T C A R E | W E A R E H E R EShockwave LithotripsyFor several years, Concord Hospital has off ered a minimally invasive life-saving procedure for patients who need a new aortic heart valve, but cannot undergo open-heart surgery. Now, a newer technique makes that procedure available with a reduced risk of complication to even more patients.TAVR, transcatheter aortic valve replacement, is a technique in which a cardiologist replaces a defective or diseased aortic heart valve by threading a new valve into place through an artery, instead of with open-heart surgery. For most patients, the new valve and the instruments needed to deliver it to the heart are threaded through the femoral artery at the top of the leg. But, for 10-15 percent of patients, a buildup of calcium inside the artery wall narrows the artery and the instruments wont fi t.In the past, the cardiologist might try widening the artery by infl ating a balloon inside and inserting a stent to hold the artery open, but that involved a risk of complication for TAVR patients. Another option was moving the new valve to the heart through an alternate access pointsometimes another artery or through a small incision in the chest. But studies have shown that patients have the best results, with fewer complications, when the femoral artery is used.A procedure call shockwave lithotripsy enables doctors to more safely widen Patrick Magnus, MD, MPH, FACC the femoral artery to make room for the valve and instruments needed for TAVR procedures. Shockwave lithotripsy is a virtually painless procedure in which a balloon containing tiny electrodes is threaded to the narrowed area. When activated, the electrodes produce 30 seconds of shockwave pulses that crack and break up calcium inside the artery wall, allowing the artery to widen. Shockwave lithotripsy has opened the opportunity for those patients to get the full benefi ts of TAVR, while reducing the possibility of complications, said Dr. Patrick Magnusof Concord Hospital Cardiology.R O C E D UP 187 RER SV SA T N I0 2 0 2 E C'