Posts Tagged ‘TAVR’

More Atlantans Avoid Open-Heart Surgery with Latest Valve Treatment

It started with shortness of breath, which Donna Jan Green had become used to given a history of heart issues going back to childhood. But it became worse. When she’d visit one of the craft shows she loved attending, she couldn’t walk far without having to sit down. It grew so bad that even going to check the mail required a long rest at the mailbox before she could muster the energy to walk back inside.

The calcifying valves within Green’s aorta—the body’s largest artery, which carries oxygen-rich blood away from the heart—were taking her breath away. It was why Green found herself at Emory’s Structural Heart & Valve Center, mentally preparing herself for open-heart surgery of the type she’d endured many years ago when her mitral valve began to fail.

At least, until she was introduced to a four-letter acronym.

“They told me, ‘You’re a good candidate for a TAVR,'” recalled Green, now 73 and a Jonesboro resident. “I said, ‘TAVR? What’s a TAVR?’ I had never heard of it before.”

She was in the right place to have her questions answered. TAVR, short for transcatheter aortic valve replacement and pronounced “ta-ver,” had been pioneered by physicians at Emory, who performed the first TAVR in the state of Georgia in 2007. Rather than the traditional procedure of opening the chest, TAVR involves replacing the valve via a catheter typically inserted in the femoral artery, reached by making a small incision in the groin. The less invasive method leads to quicker recovery times and sooner trips home.

A Leader in TAVR Research and Usage

TAVR was originally available only for frail or older patients deemed too high risk for traditional open-heart surgery. TAVR became an option for medium-risk patients after a second clinical trial, with Emory as one of the leading enrollers, which found those using the less invasive method fared better after one year than others who had undergone traditional surgery. Patients who received TAVR had roughly half the one-year risks of stroke and mortality compared to those who underwent the much more invasive open-heart route.

Emory has performed more TAVR procedures than any other health care system in Georgia. It was one of just five approved centers in the U.S. to participate in the first stages of the original PARTNER I clinical trial in 2007. Emory Healthcare has gone on to perform more than 3,000 of the procedures since 2007.

But when Green was preparing for her surgery in August of 2016, she still needed to be convinced. The findings of the clinical trial had been published only five months earlier, prompting plenty of questions about what this treatment meant.

“I said, ‘No sir, give me the old surgery,'” Green recalled. “Put me on a heart-lung, give me a titanium valve and let me go home.”

But her previous heart surgery to replace her mitral valve, in addition to breast cancer removal she underwent later, simply left too much scar tissue, doctors told her.

Green and a friend spent an entire day praying over the decision, and at last she agreed.

The TAVR procedure took approximately 45 minutes and, soon afterward, Green was awake, sitting up and trying to go back to her room to watch her beloved Boston Red Sox on TV.

It was a stark contrast to her open-heart procedure, when her mitral valve had been replaced.

“It was a long time getting better after being cut open. For about the first 24 hours, I was incoherent. I was in the hospital six or seven days. I had a hard time getting up and I couldn’t get up without help. I had a long recovery. I’m talking probably three to four months,” Green recalled.

“With my TAVR, 20 minutes after I came out of surgery, I was awake. I felt fine. I sat up on the side of the bed and everyone said, ‘Whoa, whoa, where are you going?’ I said, ‘I want to get up.'”

‘Nothing Like It Was Before’

More than two years later, “I’m doing great,” she said.

Following her TAVR surgery, she went through six weeks of heart therapy. In 2017, she was able to fly to Irvine, Calif., to meet the people who had made her replacement valve, and others who had undergone the life-changing procedure.

“It was wonderful. We had meetings, and they told us all about the TAVR. There were 50 patients and 50 caregivers, and they pumped our brains for three days. They wanted to know: Did you hurt? How did the surgery go? How do you feel now?” she said.

Green was asked to give a speech about how she decided to proceed with the TAVR surgery.

“I was really apprehensive about having it, and I let them know that they needed programs to get this information out there, because the TAVR is a wonderful invention,” she said.

The crippling fatigue that once forced her to rest at the mailbox is gone. She now takes aerobic classes three days a week.

“I struggle through it, but I continue to do it,” Green said. “I still get short of breath, and I probably always will because I’m a heart patient. But it’s nothing like it was before.”

Emory Structural Heart & Valve Center

The Emory Structural Heart & Valve Center most recently participated in the PARTNER III clinical trial that made the technique available to low-risk patients. Certain approved patients can undergo the procedure without general anesthesia and recovery takes place on the cardiac telemetry floor rather than the ICU.

Patients can make an appointment at Emory Structural Heart & Valve Center by calling 404-778-7777 or visiting to fill out an online form requesting an appointment.

Emory’s Heart & Vascular Team Make Big Strides in Fight Against Heart Valve Stenosis

Transcatheter Aortic Valve ReplacementEmory physicians recently completed their 200th Transcatheter Aortic Valve Replacement and the United States Food and Drug Administration (FDA) also approved the new transcatheter heart valve, under study at Emory since 2007, to treat severe aortic stenosis.

The device called the SAPIEN valve, developed by Edwards Lifesciences, offers a new non-surgical treatment option for patients with failing aortic valves. Emory University Hospital was one of 23 sites nationwide, and the only one in Georgia, to study transcatheter aortic valve replacement (TAVR) with the SAPIEN valve.

Aortic stenosis is a life-threatening heart condition that affects tens of thousands of Americans each year when the aortic valve tightens or narrows, preventing blood from flowing through normally.

During the TAVR procedure, doctors create a small incision in the groin or chest wall and then feed the new valve made of cow heart tissue, mounted on a wire mesh on a catheter, and place it where the new valve is needed. This offers a non-invasive way for doctors to treat patients who are not candidates for traditional surgery.

This is a major milestone in the treatment of heart disease, the development of this procedure and this FDA approval will allow us to help even more patients with valvular heart disease and could mean the difference between life or death for a countless number of patients who are too sick or weak to undergo open-heart surgery to replace their diseased valves.

My colleague, Peter Block, MD, helped lead the Emory clinical trial, along with surgical colleagues, Robert Guyton, MD and Vinod Thourani, MD.

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Dr. Vasilis Babaliaros Emory Heart & VascularAbout Vasilis Babaliaros, MD
Dr. Babaliaros is an Interventional Cardiologist at the Emory Heart & Vascular Center.  He specializes in structural heart diseases. Dr. Babaliaros traveled to France to learn the new lifesaving approach, training for several years alongside cardiologist Alain Cribier, MD, who successfully implanted the world’s first transcatheter heart valve in 2002.  He is an Assistant Professor of Medicine at Emory University School of Medicine.