Fixing the heart from the inside out

Fixing the heart from the inside out — it’s a less-invasive way to repair an aging valve. And for older patients — some well into their 90s — it’s a welcome alternative to traditional open heart surgery.

Ray Kane, valve replacement patient: “She said, ‘You’re too old for open heart surgery.’ I said, ‘Let’s go for it!’”

Ray Kane’s sharp wit may be his greatest strength. But just a few months ago, it was his weakened heart that threatened his independence.

Ray Kane: “When you get old, things change. Let me tell you they change a lot. When you get into your 90’s, you get shortness of breath. Open heart surgery, where they spilt the chest, that would be completely out of the question for me. I wouldn’t survive the surgery.”

At 96, Ray is healthy, but his body is frail. The physically taxing surgery was deemed too dangerous. But Dr. Sarah Johnson, an interventional cardiologist at Alexian Brothers Medical Center, offered another option.

Dr. Sarah Johnson, interventional cardiologist, Alexian Brothers Medical Center: “This valve is very unique. It’s like a stainless steel stent, and it has tissue sewn into it. And it’s all collapsed on a balloon so it can pass through the normal circulation without opening the chest.”

It’s called TAVR — transcatheter aortic valve replacement.

Dr. Sarah Johnson: “There’s a dark shadow in there. The valve has become calcified, stiff, and the leaflets will not open. And the heart has to pump so hard, and like any other pump, if it’s pumping real hard, it will do it for a while, but pretty soon it can fail.”

Similar to placing a stent to prop open a clogged artery — during the TAVR procedure, doctors thread a replacement valve through an artery in the leg up into the heart. Once at the site of the aortic valve, the artificial valve is deployed — its flaps opening and closing with ease … and easing the workload on the heart.

Dr. Sarah Johnson: “There it is. It’s a beautiful thing. We pushed all the calcium away when we placed the stent, and now there are new leaflets inside that stent opening and closing just like a normal valve would do.”

The procedure is not without risk — the diameter of the catheter system used could injure vessel walls as it pushes its way through to the heart. And there’s a risk of stroke.

Dr. Sarah Johnson: “That’s a fairly large catheter. It has to curve around where your aorta is to get to where the valve needs to be placed, and in doing that, there is a risk of stroke.”

Still, Ray was willing to give it a try. And now he’s happy to share his experience with others.

Ray Kane: “Oh I have a lot of confidence. I’m in pretty good shape.”

The procedure isn’t just for elderly patients — younger patients who may not be able to tolerate open heart surgery may benefit, as well. Approved in 2011, Alexian has done five TAVR procedures — Ray being the first.

To learn more about TAVR at Alexian Brothers Medical Center, go to: http://www.alexianbrothershealth.org/heart-vascular/ To learn more about Dr. Sarah Johnson, check out: http://www.alexianbrothershealth.org/DrSarahJohnson To learn more about the TAVR procedure, go to: http://newheartvalve.com/treatment-options#sthash.MhCfBlSb.dpbs

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