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Healthbeat 4: Transcatheter Aortic Valve Replacement (TAVR)

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Sioux City, Iowa -- "I felt like I was going down so I told my daughter, I've got to do something. I'm not doing anything to help myself. I'm going to try this," said Otto Albrecht.

Months after undergoing a procedure called Transcatheter Aortic Valve Replacement, or TAVR, Otto Albrecht says he is feeling pretty good.

MercyOne Siouxland Heart and Vascular Center started offering the TAVR procedure as an option last July. Interventional cardiologists at MercyOne say they have done 11 of them and they have all been successful.

96-year-old Otto Albrecht recently had a followup appointment with Dr. Glynne Edwards, Interventional Cardiologist at MercyOne Siouxland Heart and Vascular Center.

"This is what we did. We put the balloon across your valve. We used that pacer wire to stop the heart and blow it up," said Dr. Edwards.

"My breathing. I couldn't walk 10 feet without stopping, resting and getting my breath," said Albrecht.

Even with those complications, Otto initially wasn't convinced he wanted TAVR. However, he says with his oxygen levels going down, his heartbeat fading, swelling in his legs, and weight gain, he was scared and decided something needed to be done quickly.

"There's no incision. I mean they go from your groin, up through the vein so there's no incision to heal, to speak of. It's not like opening your hold chest up. I wouldn't have had that," said Albrecht.

"Through the advancement of science and multiple studies, it's actually been demonstrated that this type of therapy is actually not only safe, but as equally effective, and in some cases superior to open heart surgery," said Dr. Edwards.

Dr. Edwards says each situation is evaluated by a heart team, which includes surgeons, interventional cardiologists, nurse practitioners and others. Tests, like echocardiograms are part of the process, before it's ever decided to use TAVR.

"Otto is the oldest patient we've done so far," said Dr. Edwards.

It was determined Otto was a good candidate for the minimally-invasive procedure, which at one time was only used for the sickest heart patients.

The basic mechanics of the heart help us understand why it is necessary in some cases.

The function of the aortic valve is to open and close, which happens about 60- to 100-times a minute, according to Dr. Edwards. Over time, especially as we get older, the valve degenerates through wear and tear.

"So we can line up the valve, right at this perfect spot and then we expand the balloon and this valve which was crimped down, suddenly expands, crushes the old valve behind it and right there you have a newly-functioning aortic valve," said Dr. Edwards.

"I feel pretty good. It's helped me quite a bit," said Albrecht.

"We do have lots of patients being evaluated for the procedure. And as the word spreads, we hope to get more patients coming in," said Dr. Edwards.

Dr. Edwards says the procedure has been used in the U.S. for about eight years and was pioneered in France in 2002, but has since undergone several refinements.

He says 90% of the time, doctors go through the arteries in the groin to conduct TAVR.

The average length of a hospital stay is two days, compared to a week for surgery.

Because of the tubes used by doctors in the procedure, Dr. Edwards says there is a risk of bleeding or damage to arteries in the groin. However, a team of medical experts meet, plan and determine the best approach to take for each patient.

Stella Daskalakis

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