On May 12, 2015, the Nebraska Heart Institute Heart Valve Team successfully performed the state’s first Transcatheter aortic valve replacement (TAVR) without general anesthesia; meaning that the patient was awake during the entire procedure using conscious sedation. The TAVR procedure was performed at the CHI Health Nebraska Heart in Lincoln, Neb,. on a 78-year old patient from southeast Nebraska.
Nebraska Heart was one of the first hospitals in the United States to treat patients with the FDA-approved Edwards SAPIEN Transcatheter Heart Valve in December of 2011. The Edwards device was initially approved by the U.S. Food and Drug Administration as a therapy for patients with severe symptomatic native aortic valve stenosis who were determined by a cardiac surgeon to be inoperable for open aortic valve replacement and in whom existing co-morbidities would not preclude the expected benefit from correction of the aortic stenosis (AS).
Up to 1.5 million people in the U.S. suffer from AS, with an estimated 250,000 patients having severe AS. Studies show that without an aortic valve replacement, more than 50 percent of patients with severe AS will not survive more than an average of two years after the onset of symptoms.
“What’s exciting and revolutionary is for patients to undergo such a life-saving procedure as this without general anesthesia,” says Denes Korpas, MD, Interventional Cardiologist with Nebraska Heart Institute. “This next step takes us closer to the environment of a ‘traditional’ cardiac catheterization, where patients are up and walking around and going home the next day.”
The physicians with the Nebraska Heart Valve Team agree that this evolution subjects the patient to a less invasive overall procedure. “By eliminating general anesthesia, the patient avoids the traditional breathing tube and potential side-effects of surgical anesthesia,” says Joseph Petty, MD, Anesthesiologist with Nebraska Heart. “The less invasive we have to be, the quicker recovery for the patient.”
What use to be, only a few short years ago a major, open-heart surgical procedure, with seven to ten days of recovery in the hospital, is now done via a percutaneous approach with the patient leaving the hospital in a couple of days. “Through our association with clinical trials and now FDA approved procedures, we are able to provide patients in this region with innovated technologies that require less recovery and greater benefit in quality of life,” says Korpas.
Aortic stenosis often develops into debilitating symptoms that can restrict normal day-to-day activities such as walking short distances or climbing stairs. Some patients may experience chest pain, fainting, lightheadedness and extreme fatigue.
The Nebraska Heart Valve Team has developed a unique partnership between cardiac surgeon, interventional cardiologist, anesthesiologist and echocardiographer to establish a multi-disciplinary approach to patient care. For more information about the Nebraska Heart Valve Team and, specifically, the TAVR procedure, call 1-800-NHI-DOCS (677-3627).