February 28th, 20137 Stories of Hope: ‘It Was a Piece of Cake — Like Magic’
7 Stories of Hope: ‘It Was a Piece of Cake — Like Magic’ — Transcatheter valve replacement replaces open-heart surgery
– BY PAULA NEELY AND ROB WALKER –
Last fall, Ronald Martin, an 82- year-old professor at Lynchburg College, had trouble breathing and walking from his car to his office. “Finally, I couldn’t walk at all,” he said.
Martin had open-heart surgery 12 years ago so he worried when doctors said they might need to open his chest again to replace a damaged valve. “That first time was scary, but I guess it saved my life,” Martin said. “I didn’t want to do it again at my age.”
At his son’s suggestion, Martin went to the Pauley Heart Center at VCU Medical Center in Richmond where he met with Dr. Zachery M. Gertz, director of Structural Heart Disease. Dr. Gertz, who came to VCU in August, runs the school’s new program that offers the Edwards SAPIEN Transcatheter Heart Valve primarily to elderly and high-risk patients. Dr. Derek R. Brinster, a cardiothoracic surgeon, works with him.
Martin had severe aortic stenosis (AS), a condition caused by calcification and narrowing of the aortic valve, which controls the direction of the blood flow from the left ventricle of the heart to the aorta, the main artery that carries blood throughout the body.
FDA APPROVAL CAME LATE LAST YEAR
Gertz said Martin was a high-risk candidate for open-heart surgery because of his age and previous bypass surgery. He was eligible, however, for transcatheter valve replacement (TAVR) at VCU, one of the few hospitals in central Virginia where the minimally invasive procedure is performed. The U.S. Food and Drug Administration approved it in 2011.
The procedure involves threading the Edwards SAPIEN aortic valve replacement device over a wire inserted in a blood vessel in the groin to the aortic valve. The diseased valve is then ballooned open and the new valve is anchored in place.
“Now, instead of cracking the chest,” Gertz says, “we put this valve in with a balloon catheter, usually through the leg, and the new valve takes the place of the old one. It works beautifully.” Hospital stays usually run four to seven days rather than the 12 to 14 for open-heart surgery, and many patients do not face the monthlong rehabilitation period.
A month after his surgery, Martin said, “It was a piece of cake – like magic. I can breathe!” He is walking as much as possible and plans to return to teaching. “I feel great, and I hope I don’t have to see hospitals anymore.”
Paula Neely and Rob Walker are Richmond-based writers.
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