Bob’s Minimally Invasive TAVR Procedure for Aortic Valve Failure

Bob’s cardiologist detected what he could not feel: a heart murmur that indicated a slowly deteriorating aortic valve. It was a condition that could cause Bob’s heart to suddenly stop. Bracing himself for open-heart surgery, the 73-year-old retiree was surprised to learn that he would be able to avoid the risks, thanks to a clinical trial at Northwestern Memorial Hospital.

As the first low-risk patient in Illinois to undergo a Transcatheter Aortic Valve Replacement (TAVR) procedure, Bob benefited from a less invasive way to make his heart stronger.

Unlike open-heart surgery that surgically separates the chest, surgeons perform TAVR using very small incisions. A new valve is inserted through a catheter, or tube, via the patient’s groin or a small incision under the patient’s ribs. The procedure is performed in a cardiac cath lab, rather than an operating room, and the new valve is steered into the diseased valve, replacing it.

“My care team had been monitoring this condition for several years, and they were expecting me to have open-heart surgery, which I was dreading because of the long, painful recovery,” said Bob. “I kept putting off treatment, and then I found out about this clinical trial.”

Until recently, TAVR was only offered to high-risk or intermediate-risk patients who were not ideal candidates for open-heart surgery because of other risk factors and medical conditions. This clinical trial makes it possible for low-risk patients like Bob to reap the benefits of valve replacement without undergoing major surgery.

Within hours of having the procedure, Bob was sitting up and eating lasagna, he recalls, and was back home two days after the procedure.

“We are excited to be one of the first hospitals to offer TAVR to a broader group of low-risk patients,” said Charles Davidson, MD, who is the Clinical Chief of Cardiology at Northwestern Memorial Hospital and performed the procedure on Bob with Duc Thinh Pham, MD, Surgical Director of the Center for Heart Failure at Northwestern Memorial Hospital.

The TAVR heart team at Northwestern Memorial Hospital also includes S. Chris Malaisrie, MD, co-Director of the Thoracic Aortic Surgery Program at the Bluhm Cardiovascular Institute, and James Flaherty, MD, Director of the CCU, as well as other interventional cardiologists and surgeons.

Dr. Davidson and Dr. Malaisrie were co-principal investigators on the clinical trial and the physicians at Northwestern Memorial Hospital were the first in Illinois to participate. Since, Northwestern Memorial Hospital physicians have completed more than 500 transcatheter aortic valve replacements. Results from earlier clinical trials with high- and intermediate-risk TAVR patients showed positive outcomes that are comparable to, or in some cases, better than open-heart surgery to correct severe, symptomatic aortic stenosis—the narrowing of a valve which in turn reduces blood flow and causes the heart to work much harder. Aortic stenosis can also lead to extreme fatigue, shortness of breath, dizziness, and chest pain.

“The results of this trial, and, potentially, all of our transcatheter trials, potentially will dramatically alter the options for treatment and recovery after the procedure,” said Patrick McCarthy, MD, Executive Director of the Bluhm Cardiovascular Institute, Chief of the Division of Cardiac Surgery and the Heller-Sacks Professor of Cardiothoracic Surgery at Northwestern University Feinberg School of Medicine. “While open-heart surgery today is the preferred option for most patients, physicians at Northwestern Memorial Hospital have been at the forefront of developing transcatheter valve therapies and in 10 years likely, it will be the preferred treatment for most patients.”

With a new grandson on the way this summer, Bob has a lot more life to live – and a lot of golf to play.

“It means the world to me that everything is better. My goal is to live to be 100, and without this, there was no way that was going to happen,” said Bob. “The future is bright, and I couldn’t be happier for what Northwestern Medicine did for me.”

To learn more about TAVR and the advanced heart care options at Northwestern Medicine, visit the Bluhm Cardiovascular Institute.