At 94 years old, every day counts for Jim Bier.

The Champaign, Illinois, resident, U.S. Army veteran, and retired map-maker is able to manage things like visiting the store and strolling his backyard gardens – a space resembling the University of Illinois Japan House gardens, which Bier designed. It all comes with less chest pain and easier breathing thanks to a minimally-invasive heart procedure offered at OSF HealthCare.

“I’ve been at home, exercising, building up my legs, and I don't have the difficulties breathing like I did before all this happened back in the garden days,” Bier says. “And so I would say I'm in very good shape at this point.”

Bier pauses and adds with a chuckle, “From my waist up. I still have to work on my legs.”

Approved by the U.S. Food and Drug Administration in 2011, transcatheter aortic valve replacement, or TAVR for short, deals with a thickened aortic valve in the heart that can’t fully open. This reduces blood flow and could mean symptoms like chest pain, shortness of breath, fainting, and fatigue.

Tariq Enezate, MD, a cardiologist at OSF HealthCare Cardiovascular Institute in Urbana, Illinois, explains that the TAVR procedure begins with making a small cut near the patient’s groin. The doctor then inserts a small catheter – “smaller than my little finger,” Dr. Enezate notes – and guides it up to the heart to insert a new valve. This is opposed to the more invasive open-heart surgery, which can lead to a longer and more painful recovery for the patient. Minimally-invasive surgeries like TAVR also avoid the need to stop the patient’s heart.

“Those patients are old. They have a lot of diseases. So, many of them, they are not good candidate for surgery. And the surgery team might think they might not be in good shape and strong enough to handle the stress of open heart surgery,” says Dr. Enezate of potential TAVR patients. “In those situations, TAVR is actually lifesaving.”

For Bier, the lifesaving series of events began on Christmas Eve of 2021. By then, Bier had been dealing with heart problems for nearly a decade and had used a blood thinner after open heart surgery didn’t yield the best results. But a visit to the emergency department that day turned into a week-long stay and the question: What more needed to be done? Eventually, Bier says doctors told him about one last surgery that was needed – “the big one,” as Bier puts it. He needed a new heart valve.

An avid reader, Bier researched the TAVR procedure to allay his concerns.

“I’m a person who goes with the flow,” Bier says. “You talk to any of the nurses who've dealt with me at the hospital. They're saying all the time, ‘Go with the flow.’ That's what I kept telling them all the time. And in that way I'm pretty optimistic about it.”

Still, Dr. Enezate recognizes that even minimally-invasive heart surgery may cause stress. He says the patient’s care team – everyone from the cardiologist to the anesthesia team – meets with the patient and their family several times before the procedure.

After TAVR patients go home, Dr. Enezate explains, they eventually will enter cardiac rehabilitation to rebuild the strength needed to do the everyday activities they love. Other appointments with a provider and medications like a blood thinner are also typical.

“We have a big team of doctors, nurses, nurse practitioners, therapists, social workers, and so many people,” Dr. Enezate says. “Take care of the patient, take care of their family, answer their questions, get the tests, the procedures that they need. And after the procedure, we are on top of things.”

At OSF HealthCare Heart of Mary Medical Center in Urbana, where TAVR recently launched, that team includes Dr. Enezate, Ashraf Al-Dadah, MD, Alaa Ujayli, MD, and Kelli Lamaster, the cardiac program coordinator. Each of them undertook years of schooling and training to be able to successfully oversee operations like TAVR.

“If you asked a cardiologist 10, 20 years ago and you tell them a patient with valve replacement can go home next day, they would think that you're crazy,” says Dr. Enezate. “But now, it is reality.”

Visit the OSF HealthCare TAVR website for more information and to find a provider near you.

Interview clips - Jim Bier

B-Roll

Previous TAVR stories from the OSF HealthCare Newsroom

Mick Jagger Recovering After TAVR Procedure - April 5, 2019

Forging the Path – TAVR for Congenital Heart - December 10, 2021

New Innovations are the Heartbeat of TAVR - November 3, 2022

Medical technology is constantly evolving and improving. Over the past decade, one of the most notable innovations in interventional cardiology and structural heart procedures has been the emergence of transcatheter aortic valve replacement, or TAVR. 

TAVR allows patients suffering from aortic stenosis (narrowing of the aortic valve opening) to receive a new aortic heart valve, typically without a surgical incision. This is a repair that previously required an open heart procedure, and wasn’t even an option for some patients who were considered too sick for major surgery.

 Now these patients are getting the valves they need through TAVR. The procedure delivers a balloon expandable aortic heart valve via catheter, replacing the diseased valve while the heart continues to beat – avoiding the need to stop the patient’s heart.

 OSF HealthCare offers TAVR at three of its Illinois facilities: in Peoria at OSF Saint Francis Medical Center, in Rockford at OSF Saint Anthony Medical Center, and most recently in Urbana at OSF Heart of Mary Medical Center.

 The OSF Cardiovascular Institute TAVR team in Peoria has been offering the procedure for ten years now, and has adapted new innovations along the way. The most recent is a new version of the heart valve implant that early studies show better resists calcification and valve deterioration post-implant. Dr. Sudhir Mungee is the director of the structural heart program for OSF HealthCare.

 “This new technology was FDA approved in September and sure enough, we were the first, not only the state of Illinois, but I think Illinois, Wisconsin, Kansas, in this entire region, we were the first to adapt this technology. We treated our patients since then, and every patient now of ours is getting the most advanced TAVR valve,” says Dr. Mungee.

While the new valve, called the SAPIEN 3 Ultra RESILIA Transcatheter Heart Valve, is currently only available at OSF Saint Francis Medical Center, Dr. Mungee is confident the TAVR teams at OSF Saint Anthony and OSF Heart of Mary will soon adapt the technology as well.

 What makes this valve different is a new anti-calcification tissue treatment that, according to the manufacturer, prevents structural valve deterioration at five years post-implant. This provides the potential to extend the durability of the valve. Dr. Mungee says he is optimistic this new technology will be a great benefit for patients, and looks forward to watching the progress of his patients.

 “We'll have to wait for the five year data, the 10 year data, but I think as an operator, or as a consultant when we talk to the patients, we will be a little bit more confident to tell them that there is a likelihood that this valve is going to last even longer than the predecessors,” he says.

 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.

 Dr. Mungee says the faster recovery and immediate improvement of a patient’s quality of life is nothing short of miraculous, as he reflects on the past decade of TAVR innovations.

 “We used to be 20 people in the operating room and did two valves in a day,” he recalls. Now we do about six valves in a single day with four people in the room. Most patients go home the next day. The procedure, which used to be general anesthesia, now is done under local anesthesia. Patients can be talking to us while they're getting their heart valve replaced.”

 To learn more about TAVR, or to see if you are a TAVR candidate, visit OSF HealthCare's TAVR information page here.

Interview Clips - Dr. Sudhir Mungee

B-Roll - Dr. Sudhir Mungee