New treatment option is a “game changer” for patients who can’t risk open heart surgery.
Concord, Calif. (August 23, 2012) – Physicians at John Muir Health announced today that they have successfully performed eight transcatheter aortic valve replacement (TAVR) procedures. John Muir Health was recently selected by Edwards Lifesciences as one of only three hospitals in the Bay Area and 175 – 200 in the United States to perform TAVR procedures. The first TAVR procedure at John Muir Health was performed on June 14 and the patient was discharged home four days later.
“This new procedure is the single most important advance in interventional cardiology since the invention of the coronary stent. We are honored to be among the few hospitals selected in the U.S. and one of only three hospitals in the Bay Area to perform this remarkable new procedure,” said interventional cardiologist Gary Gershony, M.D. According to interventional cardiologist Neal White, M.D. “This is a game-changer for many critically ill patients who previously did not have other satisfactory treatment options.”
Werner Fend, a 90-year-old patient from Alamo was one of the first people to undergo the procedure. “Before my procedure, I had trouble breathing while walking when playing golf. Now that my breathing is getting better, I’m hopeful to get back to my golf game again soon,” said Mr. Fend. “My experience with staff, nurses and doctors at John Muir Health has been wonderful. This was a great option for me to help me get back to doing some of the activities I love.”
The recently FDA-approved Edwards SAPIEN Transcatheter Heart Valve (SAPIEN THV) is the first artificial heart valve that can replace a severely stenotic (narrowed) aortic valve without open-heart surgery. The FDA’s approval of the SAPIEN THV was based on a study of 358 patients who were not eligible for open-heart surgery. Half of the patients received the SAPIEN THV and the other study patients received treatment with the best available medications. The patients treated with the SAPIEN THV had a highly significant improvement in survival and quality of life during the two-year follow-up.
“The transfemoral (through the femoral artery in the groin) approach to this procedure is designed for patients with aortic stenosis who are not candidates for conventional open-chest valve replacement due to their age, other medical problems, and the risk surgery might pose to them,” said cardiac surgeon Ramesh Veeragandham, M.D. According to cardiac surgeon Tanveer Khan, M.D., “These patients are currently not candidates for open heart surgery and TAVR provides a treatment option that simply was not available to patients with severe aortic valve stenosis in the past.”
Aortic valve stenosis is a progressive, age-related disease caused by scarring and calcium deposits on the aortic valve that cause the valve to narrow. This narrowing prevents the valve from opening fully, which obstructs blood flow from the heart into the aorta and onward to the rest of the body. As the heart works harder to pump enough blood through the smaller valve opening, the heart eventually weakens, which can lead to problems such as congestive heart failure, fainting, chest pain, irregular heart rhythms or cardiac arrest.
The SAPIEN THV is comprised of cow tissue (similar to that used in the traditional surgically implanted valves) stitched to a stainless steel mesh frame. To replace the diseased valve, the SAPIEN THV is compressed onto the end of a long, thin, tube-like device called a catheter. The catheter and SAPIEN THV are inserted into the femoral artery through the groin and advanced to the site of the diseased valve. The Sapien THV is then released from the catheter and expanded with a balloon, replacing the patient’s native aortic valve.
The TAVR team at John Muir Health includes physicians, a nurse practitioner and physician assistant, and catheterization laboratory and operating room staff. The physicians include interventional cardiologists Gary Gershony, M.D. and Neal White, M.D., cardiac surgeons Tanveer Khan, M.D. and Ramesh Veeragandham, M.D., imaging cardiologists Paul McWhirter, M.D. and Mark Nathan, M.D., interventional radiologist Ira Finch, M.D., and cardiac anesthesiologist David Fitzgerald, M.D. An interventional cardiologist, cardiac surgeon, imaging cardiologist and cardiac anesthesiologist participate in each TAVR procedure.
John Muir Health recently added a six-story patient care tower to its Concord campus. The artfully designed, $200 million tower houses a new Cardiovascular Institute with 61 private patient rooms and an expanded emergency department. The Cardiovascular Institute features five cardiac catheterization suites, 16 pre-operative and recovery beds, a dedicated 12-bed cardiovascular ICU (with 24 hour, real-time audio and video monitoring of patients), 49 monitored telemetry beds, and a separate entrance and lobby.