TAVR Treatment Offering Hope To Aortic Stenosis Patients
Needing a heart valve replacement used to mean open heart surgery, but now doctors are doing it in a much less invasive way.
“We call him Superman. He’s always been our Superman. We truly thought we were losing him,” says John Lieberman’s daughter, Amy.
He had a problem with one of his heart valves — a problem that nearly cost this Superman his life.
“I was sort like out of breath at times, if I went up the steps, and I would stop half way, or a third of the way, and then continue on,” he says.
Aortic stenosis happens when the aortic valve, becomes calcified, stiff and tight. The heart has to work harder to pump blood out to the body, and the heart gets weaker, leading to fatigue, shortness of breath and swelling in the legs.
Without any intervention, death is the usual outcome.
Typically, doctors would do surgery to fix the issue — take out the old valve, and sew in a new one — not a matter to take lightly.
“Once you start operating on people that are elderly, especially around the aortic valve, you “increase the risk of infections and stroke,” says Dr. Andy Kiser, a cardiac surgeon at St. Clair Hospital.
Doctors came up with a new way, called Transcatheter Aortic Valve Replacement — or TAVR.
With thin tubes and wires, they go through the blood vessels to get a new valve up to the heart.
“This way, the new way, the transcatheter valve way, we don’t take the valve out at all. We just actually blow a balloon up, that pushes the old valve out of the way, and it wedges the new valve in, and starts working immediately,” Dr. Kiser explains.
At first, this technique was reserved as a last resort, and for high risk patients with lots of other health conditions that would make surgery risky. The outcome in those patients was so good, the Food and Drug Administration recently approved its use in low risk patients.
“Surprisingly, the low risk outcomes are as good as, and and in some situations, even better than surgery in some patients, at least at a year,” Dr. Kiser continues.
“The recovery time is amazing. Patients go home the next day, or two days, and they’re back on their feet right away,” says Allegheny Health Network cardiothoracic surgeon, Dr. Scott Halbriener.
The device is made with a metal ring and cow heart valve leaflets. No one knows how long this valve will last, but best guess is 15 years, based on similarly constructed valves. So for younger patients, this would not be a good option.
Also, because of how it goes in, there’s a small chance of needing a pacemaker afterwards.
“Less than 1% risk of dying from the procedure,” says Dr. Halbriener.
While the TAVR valve costs $11,000 more than a standard valve, the savings in operating room and hospital costs makes the two approaches economically comparable. But for patients, the decreased recovery time is priceless.
“We were walking the streets, doing the exercises he was supposed to be doing, walking the streets that next day. It was amazing, truly,” says Amy.
“They have to be some of the most grateful patients that I think we see,” says Dr. Halbriener.
By Dr. Maria Simbra – Reporter, KDKA