July 03, 2013
In November 2012, a, lifesaving heart procedure called transcatheter aortic valve replacement (TAVR) was introduced in southwest Michigan. The first in the region was performed at Bronson Methodist Hospital. Since then, cardiac patients who have run out of treatment options are getting a new chance at life.
TAVR is currently the only method other than open heart valve replacement approved for commercial use in the United States for people suffering from severe aortic stenosis. Severe aortic stenosis is a hardening or narrowing of one of the heart valves. Nearly 1.5 million Americans have the condition, but up to 30% of them are not healthy enough to be candidates for standard open aortic valve replacement, which requires going through the breastbone and temporarily stopping the heart.
The procedure which was first offered in southwest Michigan last fall used a transfemoral approach allowing surgeons to reach the patient’s heart by guiding a catheter through the femoral artery in the groin.
Now, because of the high success rate of that procedure, the TAVR team, a collaborative between Lakeland Healthcare and Bronson, is offering another innovative option to reach even more hard-to-treat heart patients.
Roy Kidney of Battle Creek, was the first patient to receive the new, transapical approach. He knew he’d had a bad heart valve for about ten years. His doctors kept an eye on it with stress tests and cardiograms but it kept getting worse. His only option would be to eventually have an operation.
Like the transfemoral TAVR method introduced last year, the transapical approach is designed for patients who need a new aortic heart valve, but who are not likely to survive open-heart surgery.
The new transapical approach is for patients whose arteries that will not allow a catheter to pass from the groin up to the heart. Surgeons instead enter the patient’s aortic valve through the bottom of the heart, but the method does not require open-heart surgery, only a very small chest incision.
“I wasn’t a candidate for open heart surgery because I had bad lungs,” said Kidney. He met with the TAVR team to see if he was a candidate for the transfemoral approach, but a stent in his aorta and a blockage in an artery in his legs rendered him ineligible. They determined that accessing his heart through the chest would be the best and only option.
The decision to use TAVR and the selection of the approach, transfemoral or transapical, is made in Bronson’s Heart Valve Clinic. At the clinic, patients meet with interventional cardiologists, cardiothoracic surgeons and a coordinator to discuss further options for treatment.
“It’s wonderful to be able to give patients and families multiple options,” said Bronson cardiothoracic surgeon, Alphonse DeLucia, MD, “especially considering the poor prognosis of severe aortic stenosis without any type of valve replacement.”
Kidney’s success with TAVR bodes well for future cardiac patients in the region. He’s recovering steadily and looks forward to improved quality of life. “Before my operation all I did was sleep. I couldn’t do anything because I got tired right away. I’d walk to the bathroom and have to sit 20 minutes to catch my breath.” He now has more energy and is considering playing golf.
Kidney didn’t think too much about being the first patient for the transapical approach, he said. “For sixty years I’d been telling my wife I wouldn’t go to see doctors, but being afraid never entered my mind because I trusted what they were doing.”
Because of the TAVR team’s experience and success rate, Bronson Methodist Hospital is the only hospital in the region where physicians are approved to offer both types of TAVR procedures.
For more information about TAVR, call the Bronson Heart Valve Clinic toll-free at (855) 338-7654.