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Your Healthy Family 2017 Review: TAVR is new option to open heart surgery

Posted at 8:13 PM, Jan 02, 2018
and last updated 2018-08-13 22:29:43-04

COLORADO SPRINGS – As we continue reviewing some of the most informative stories from 2017 I wanted to revisit the topic of Aortic Stenosis.  It’s one of the most under diagnosed deadly diseases in the United States and there’s a new treatment option to open heart surgery, available at UCHealth Memorial to replace a defective heart valve.

Following our story about aortic stenosis, that use to be generally treated with open heart surgery to replace the broken valve.  Aortic stenosis is one of the most under diagnosed deadly diseases in the United States, and open heart surgery is still the gold standard, but now there is a new less invasive option in some cases that is available in Southern Colorado to replace a defective heart valve.

Cardiothoracic Surgeon Dr. Peter Walinsky is the Medical Director of Thoracic and Vascular surgery and UCHealth Memorial in Colorado Springs and specializes in transcatheter aortic valve replacement.  “The other option besides open heart surgery that we now have, and it’s been commercially available for about the last five years is transcatheter aortic valve replacement.  That’s replacing the aortic valve without opening the chest, without going on the heart lung bypass machine.  The valve the new valve is implanted inside of a stent.  The stent can go in through a small poke hole in the leg and it goes up through the aorta, across the native aortic valve, and then the stent is inflated on a balloon, that basically displaces the old narrow calcified valve.  The stent holds the old valve open, the new valve is inside the stent, as soon as the balloon is deflated the new valve starts working and the patient is better.”

The procedure generally takes place in a hybrid operating room, a combination of an operating room and a cath lab where the surgeon can see in real time exactly what he’s doing inside a patient without having to cut them open.

Looking at video of a completed TAVR procedure, Dr. Walinsky point out, “This is an after shot of a transcatheter valve implantation.  This is a pigtail catheter right here which is injecting contrast to show us, that the valve is implanted in perfect position.  You can see the coronary arteries are still open that the valve is working nicely because there’s no contrast going into the heart itself, so there’s no leaking of the valve.”

Open heart surgery can take up to a week in the hospital to recover from while a successful transcatherter aortic valve replacement, produces seemingly instant results and patients generally go home the next day.

“The results from aortic valve surgery the results are fabulous,” says Dr. Walinsky.  “We had we had an 86 year old guy in the hospital who was so symptomatic from his aortic valve stenosis that he literally could not get from his bed to the bathroom to go to the bathroom he was so short of breath.  We did his transcatheter valve, and the next day when I went to see him he looked at me and said, ’I can breathe’.  A week later he was walking next door to his daughter’s house and doing her gardening for her.”

Dr. Walinsky takes personal pride in the fact that this procedure is now available in Colorado Springs, and so many older patients who are the group most stricken with aortic stenosis, no longer have to travel outside of Southern Colorado to find relief.