Five Years of Changing Hearts with TAVR
Valve Replacement Option is Gaining Ground and Saving Lives
More patients across the country are taking an easy breath, thanks to a procedure that dramatically improves quality and quantity of life for patients with aortic stenosis. Now OSF HealthCare Cardiovascular Institute physicians who specalize in TAVR are focusing on the future, while reflecting on the past five years of offering Transcatheter Aortic Valve Replacement, or TAVR.
You don’t have to feel short of breath when you walk to the bathroom. They’ll tell you the next morning, ‘I can breathe.’ That’s how much of a difference TAVR makes, and how quickly that difference is felt.
“I feel that this five year journey has been a very gratifying journey," said Dr. Sudhir Mungee, an OSF HealthCare Cardiovascular Institute Interventional Cardiologist. "I think we have learned a lot, I think we have improved as a team from every aspect, from technology to patient care, and I just feel blessed that we have been able to be part of this whole procedure here at Peoria. And I think for the central Midwest population, they should know that they have one of the finest centers in the country to get their heart valve being evaluated here.”
TAVR, is a procedure for patients with severe aortic stenosis (narrowing of the aortic valve opening). The procedure uses a balloon expandable aortic heart valve – placing it into the body via a catheter-based delivery system. The valve is designed to replace a patient’s diseased aortic valve while the heart continues to beat – avoiding the need to stop the patient’s heart.
Peter Hanssen has always been active and fit, making yearly bikes trips around his native South Africa and other countries with his wife, Wanda. They were on such a trip in Italy a year ago when he suddenly was fatigued, short of breath, heart racing, and struggling to keep up. Despite his above average level of fitness - especially when you consider he was 80 years old - Hanssen was diagnosed with severe stenosis of the aortic valve and calcification of the valve.
"We did a lot of research on people who had done it, but no one told me it was painless - just pick a good doctor and a good hospital, that's the main one. It was an amazing experience, and you think to yourself 5-10 years ago they opened you up and tore open your chest, and now it's so easy," said Hanssen.
In past five years that TAVR has been available in Peoria, the procedure has made some major leaps forward. In late 2016, TAVR was approved by the FDA for intermediate risk patients. Previously, it was only approved for heart valve patients deemed high-risk surgical candidates – those too sick to undergo open heart surgery. This new intermediate designation means more patients will get the new heart valve they need, without the need for open heart surgery.
Because the TAVR procedure has been such a success for high risk and now intermediate patients, physician have high hopes it will soon be available for all aortic stenosis patients.
“I think this is just the beginning, because after dealing with high risk and intermediate risk patients, with TAVR, the procedure for valve replacement, it’s going to be, likely to be accepted for low risk patients," said Dr. Mungee. “There are not a whole lot of challenges left before the low risk is approved, but of course it has to go through the proper evidence and FDA approval before we can have this for most of our population.”
The less invasive TAVR procedure also comes with a quick recovery time. Most patients will leave the hospital in an average of four days, and can resume all normal activities within 10 days of the procedure. In comparison, traditional open chest surgery patients need up to seven days of hospitalization and six weeks of rehabilitation.
Hanssen's 45-minute procedure was followed by a recovery that had him back on his bike in a matter of weeks.
"That next day my heart was back to 65% ejection fraction, and that was normal. And it wasn't long we were on the bike again, and so it was a fabulous recovery," said Hanssen. "I felt like a new tractor with rings on the next day!"
The OSF Cardiovascular Institute TAVR team in Peoria now takes the procedure a step further, by using the Minimal Approach TAVR (MA-TAVR) method. For a patient it means a new heart valve, without a surgical inscision. Dr. Mungee reflected on how far the procedure has come.
“When we first started the procedure, it used to be patient in complete anesthesia, needing a breathing machine, maybe 20 people in the room," he said. "Now it’s done minimally, meaning patient is actually breathing on their own, they’re not on a breathing machine. We give some light sedation so they don’t feel anything, it’s done under local anesthesia. There are no skin cuts on the body, we put sutures from outside in, and we are deploying the valve in a beating heart while the patient is talking to us.”
OSF HealthCare offers TAVR at two of its facilities: in Peoria, Illinois at OSF Saint Francis Medical Center, and in Rockford, Illinois at OSF Saint Anthony Medical Center.
To learn more about TAVR, or to see if you are a TAVR candidate, visit OSF HealthCare's TAVR information page here.