Aortic stenosis is when the heart’s main valve becomes stiff and narrowed, making it harder for blood to flow to the rest of the body. When it becomes severe, it can lead to life-threatening complications, even sudden cardiac death.
That’s why treatment is so important. Memorial Health will soon offer a new, less invasive option called “TAVR”, or Transcatheter Aortic Valve Replacement, becoming the first hospital in southwest Oklahoma to provide the procedure.
Until now, one of the primary treatment options at Memorial Health has been “SAVR”, or Surgical Aortic Valve Replacement, which requires open-heart surgery.
According to Dr. Ahmed Elkaryoni, a cardiologist at Memorial Health, for many elderly patients, that level of surgery simply isn’t an option.
“Because you’re not going to come to someone who’s 85 and say, ‘Hey, you do have a tight valve, we can open your chest for open-heart surgery to replace your valve,’ they’re going to say no,” he said, “The surgeon is going to say also no, because this patient is not going to make it out of the operating room.”
Yet, aortic stenosis most commonly affects people 80 and older, the very patients who may not tolerate major surgery well.
Instead of opening the chest, doctors make a small incision in the groin and guide a new valve up to the heart using X-ray imaging.
“We go in the groin with tubes under X-ray guidance,” Elkaryoni said, “We go up to the heart, we cross the old aortic valve, and then we bring our catheter that’s holding the new valve across from that old aortic valve. Then, we start to open that new valve and that pushes the old valve to the side wall, which acts as an anchor for the new valve. Then, we take some pictures with the X-ray, take some pictures with the echocardiogram, which is the ultrasound for the heart.”
He added, “We take our equipment out, we close the groin with some sutures, and then the patient goes to the intensive care unit for monitoring. Next day they should be home.”
Since it’s a minimally invasive procedure, anyone undergoing TAVR can actually stay awake during treatment.
“We give the patient conscious sedation, which means that the patient is awake during the procedure. We do not do general anesthesia because the patient doesn’t need it. Actually, general anesthesia for older people sometimes doesn’t go well,” Elkaryoni said.
Recovery is faster, too. Most patients spend one night in the ICU for monitoring and are home the next day.
For patients across southwest Oklahoma, having TAVR available locally and being the first in the region to offer it means they can get their heart care close to home, without having to travel hours to get it.
And patients are able to get back to living their lives feeling much better.
“They feel significantly different, mainly the shortness of breath. A lot of people do feel like they are able to do more at home. It improves the quality of life,” Elkaryoni said.
While TAVR valves typically last eight to 10 years, doctors can perform a valve-in-valve procedure if needed.
“So usually, the durability for the valve, because that’s the question, how long this valve is going to last,” Elkaryoni said, “Usually, the valve lasts for about eight to 10 years. And now we can do valve-in-valve. Like, let’s say someone is 80, got a valve, and the valve lasts with the patient until they are 90. So, then they have some symptoms or degeneration in the valve that we give to them.”
He added, “So, then we go back again with the same technique, and we put valve in valve.”
That can give people living with aortic stenosis many more years of life.
And compared to SAVR, TAVR often requires less long-term blood thinner medication.
If you’re experiencing shortness of breath, chest discomfort, unusual fatigue or fainting, talk to your doctor. Early detection of aortic stenosis can save lives.
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