New procedure replaces heart valve without open surgery

Sarah Newman’s birds in Thomson miss her, but they won’t for much longer.

Newman, 88, who was a poor candidate for surgery, instead got a new valve-replacement procedure this week at University Hospital that is less invasive, might get her home quicker, and will improve her quality of life now and keep her from coming back, clinicians said.

Newman on Tuesday got transcatheter aortic valve replacement, or TAVR. Doctors were able to guide a replacement aortic valve up into her heart to improve blood flow issues that were due to a narrowed opening.

University began offering the procedure earlier this year and is one of five heart centers in Georgia and South Carolina to be able to offer the service, officials said.

Interventional cardiologists Kraig Wangsnes and Les Walters had been working for two years to bring the procedure to University. It can go to only high-volume heart centers and requires a tremendous amount of investment by University, in addition to training and commitment from more than 30 people, Walters said.

“We have eight doctors in the room and about 25 technicians and assistants on these procedures, just a huge team effort to do this,” he said. “That’s the biggest thing is to pull together a team like that, that likes each other and works together well.”

Patients are seen by cardiologists and heart surgeons at the same time, which helps patients who would find it difficult to get to several appointments, said Susie Wodarz, the valve clinic coordinator in the Structural Heart Clinic at University.

“It has to be turned down by the surgeon or thought to be an extremely high risk” for surgery, Walters said. “If they are low risk or intermediate risk, they go to surgery. If they are high risk, or inoperable, they come to us.”

About 30 percent of the 250,000 patients with severe aortic stenosis – or extreme narrowing of the aortic valve – are considered poor options for surgery and without some other procedure might just dwindle away, Wangsnes said.

“Your heart is trying to pump blood through a pinhole,” he said. “It doesn’t work.”

In Newman’s case, a long tube called a catheter was threaded up through an artery in her groin into the aortic valve and then inflated to enlarge the opening. The replacement valve was crimped down to a size so it could be threaded via the catheter up into the aortic valve opening and then popped into place. The valve began functioning immediately. All of it has been carefully measured, calculated, evaluated and adjusted within millimeters.

For Newman, the effect was immediate, said her daughter, Barbara.

Before the procedure, Newman complained of being short of breath.

“When I get up to do anything, I would have to just sit down and rest for a while and then get up and finish my job,” she said.

Now, just three days after her procedure, “I know it’s going to get better but I can tell a difference already,” Newman said. “I feel much, much better.”

Because she was able to get the procedure, Newman was able to avoid the potential complications with an open procedure, such as the chest wound and being put on a bypass pump.

“She avoided all of that because her heart was still beating, pumping normally,” Wangsnes said.

Newman is likely to go home over the weekend, Wodarz said, possibly as early as today. The patients tend to average about three to five days in the hospital compared with five to 10 days for the open procedure, and could also be less likely to be rehospitalized, she said.

All that means Newman will soon rejoin the eight cockatiels and parakeets she rescued, Barbara Newman said.

“We kind of have our own little flock there,” she said. “They miss her. They’ll look back at the chair where she usually sits like, ‘Okay, what did you do with her?’ ”
In addition to her birds, Newman said she wants to get out and work in the yard and in her herb garden.

“That’s the most wonderful thing about this is the quality of life can stay,” her daughter said. “That’s the value to me. (My mother) is not armchair, not rocking-chair friendly. She likes to get up and be active.”

And that’s important, Wangsnes said.

“She can remain independent,” he said.

“I think you live longer when your life does not depend upon people doing things that you can do for yourself,” Newman said.

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