Heart valve replacements without open-heart surgery are becoming more and more common

Published: Sep. 15, 2022 at 7:04 PM CDT
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SPRINGFIELD, Mo. (KY3) - Open-heart surgery was the only way to replace heart valves. But over the last decade, modern medicine has made significant advances that allow patients to get it done without needing a stitch.

It’s known as “transcatheter aortic valve replacement” and uses an artificial valve with an outer polyethylene skirt surrounding the replacement tissue.

“It’s pericardial tissue that’s taken out of a strain of bovine cattle,” pointed out Dr. Dave Cochran, a Mercy Cardiologist and Vice-President of Heart, Lung, and Vascular Services.

That artificial valve is placed inside a catheter and inserted through a small incision in the thigh, where it travels along a wire until it reaches a narrowed valve in the heart due to excessive calcium buildup. The poorly functioning valve is pushed aside, and the new valve starts working immediately.

All was done with only minor sedation for the patient.

It’s comparable to how stents are used to open up heart arteries.

“Kind of like a coronary stent, just much, much bigger,” Cochran said.

Mercy started doing the procedure soon after it was approved in 2012 and was part of nationwide clinical tests to monitor its success.

“We’ve been on the forefront from the very beginning since the FDA first released the procedure,” Cochran said. “We’ve been doing this now for over ten years and just now completed our 1,000th TAVR procedure.”

75-year-old Don Johnson was that patient number 1,000 after having his procedure done near the end of August.

“It was a very simple procedure, quite honestly,” Johnson said. “Dr. Cochran saw I had buildup around my valves and suggested it. It sounded a lot better than open heart surgery. I’m glad I did it. The day after the procedure, I was ready to get home and live my life. I felt so much better.”

And certainly not as bad as open-heart surgery, which could have taken 12 weeks to six months to recover fully.

“Hey, I worked eight hours yesterday mowing all day,” he said. “So that ought to tell you something right there.”

CoxHealth also started the procedure in 2012 and, according to Cardiac Surgeon Dr. Matt Parmley, has done “probably in the 600-800 range.”

And while the non-invasive heart valve replacement was once only used on those who couldn’t survive open-heart surgery, it has now become commonplace for many patients (but not all).

“This truly is the wave of the future for treating valvular heart disease,” Parmley said. “We saw patients that we would have flat out turned down for surgery and had nothing to offer them. They would have died of heart failure but survived and did well. In 2019 it was released for everyone. It takes away stopping the heart, putting it on bypass, making an incision, and opening your chest. And honestly, that was the biggest cause of morbidity and mortality in the patients.”

“This procedure is nice because we’re not opening the chest, so therefore the recovery in the hospital is much shorter,” Cochran said. “There’s also less chance for complications.”

“We had a 97-year-old last week who walked out of the hospital the next day and felt better than she had in years,” Parmley added. “That’s why it’s different.”

And if you’re wondering about indications that you may need a heart valve replacement?

“Symptoms are they’re tired and short of breath, and if it gets too bad, they start to pass out,” Parmley explained. “A lot of people don’t realize they have it because they think, ‘I’m 75-80 years old, and I’m supposed to feel tired and feel short of breath if I do activity. Plus, it comes on slowly, so people just feel like it’s a part of getting old or being out of shape. But really, they have a structural problem with their heart that we can treat.”

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