TAVR: A look at a new alternative to open-heart valve replacement surgery

When it comes to matters of the heart, finding the right treatment or surgical fix is imperative to getting a person back on their feet.
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MercyOne Siouxland Medical Center is one of the top cardiac centers in the region and Siouxland News got the chance to see a new technique for an open heart valve replacement and meet a patient who went through the TAVR procedure herself.

Ellen and Ed Schwarten are world travelers. Residents of Emerson, Nebraska, the couple has been on adventures around the globe.

"We just enjoy life," Ellen said during a recent doctor's appointment, "and now I've been given some more time by having this procedure and I'm really happy about it."

For the last several years, Ellen's doctors have been monitoring an issue with her heart. She was diagnosed with aortic stenosis or a tightening or restricted opening of the aortic valve in the heart and when it came time for Ellen to have that valve surgically repaired, it was suggested the TAVR, or transcatheter aortic valve replacement procedure, was right for her.

"It's a percutaneous technique where we place the aortic valve by inserting plastic tubes into the groin arteries, and basically a new valve is mounted onto a balloon," said cardiothoracic specialist Dr. Glynne Edwards with MercyOne. "And it's basically a fancy procedure for stenting the old valve and deploying a new valve immediately. That's immediately functional right at the time of the procedure."

This procedure is relatively new, created in the last decade and is an alternative to an open-heart procedure. MercyOne Siouxland Medical Center has been performing this technique for about 18 months.

"It's the alternative to the standard, or what used to be considered standard of care, for aortic valve replacement," Dr. Edwards said, "which was surgical aortic valve replacement where the surgeon does what is called sternotomy, which is an incision usually in the middle of the chest or sometimes along the side of the chest wall.

TAVR is done while the patient is awake and recovery time is much shorter.

"Your patients are usually minimally sedated and if they are intubated or put to sleep, they are extubated right after the procedure," Dr. Edwards said. "So it's generally a much shorter length of stay and greater patient comfort, recovery sooner. Patients can return to their you know usual activities in a much shorter timeframe."

When Siouxland News met Ellen and Ed, Ellen was one week post-TAVR procedure.

"But I was awake during the whole thing. I was not put out, and it's better if you can do that and I did that. I heard him talk and everything," Ellen said thinking back on her procedure a week earlier.

The TAVR procedure is quick, taking around 60 to 90 minutes and patients like Ellen are home in a day or so. A much better alternative to the long stay and recovery that comes after an open-heart procedure.

"If you look at the number of open-heart procedures or valve replacements being done nationally. 10 years ago, 80 to 90% of open-heart valve procedures were done surgically," Dr. Edwards said. "In 2020, that's about 50% being done surgically and the other 50% being done by this transcatheter technique called TAVR."

Just one week after her valve replacement, Ellen was doing great. She showed me the four electrodes she had to wear 24/7 for 30 days to monitor her heart and any cardio events she has during her recovery.

Doctors at MercyOne have been doing the TAVR procedure for about 18 months and with patients like Ellen, see just how significant an impact this less-invasive procedure can have on someone's life.
"I would think that if nothing was done that my life would be shortened," she said. "I think I got a few more years. I'm 87 and so I'm thrilled living that long."

As with any medical procedure, the TAVR procedure may not be right for everyone. Doctors recommend you talk with your own physician before having any procedures done.

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