December 10, 2012
The Michael E. DeBakey VA Medical Center (MEDVAMC) is the first VA, and only one to date, to offer an innovative, artificial heart valve. Recently approved for commercial use by the U.S. Food and Drug Administration, the Sapien heart valve made by Edwards Lifesciences is implanted through a catheter as an alternative to open heart surgery for patients with inoperable aortic valve stenosis disease.
Korean War Veteran Werner Lee Anderson, 81, of League City, Tx., received this transcatheter aortic valve on April 18, 2012. A survivor of the Battle of Chosin Reservoir, Anderson vividly remembers feeling “10 feet tall and bulletproof” when he first joined the U.S. Marines. In the battle, his front teeth were knocked out during hand-to-hand combat and a large machete cut his hand. Anderson also injured his back when he fell into a foxhole on top of a dead comrade’s helmet. He recalls how of the 96 Marines in his unit, only six came back alive.
Previously, Anderson had five cardiac stents and two triple bypass operations. Due to his age, it was deemed too risky for conventional surgery. “In addition to his advanced age and aortic valve stenosis, Mr. Anderson suffers from coronary artery disease, hypertension, hyperlipidemia, osteoarthritis, and has had colon and knee surgeries in the past,” said Biykem Bozkurt, M.D., Ph.D., MEDVAMC Cardiology chief and professor of Medicine at Baylor College of Medicine at Baylor College of Medicine (BCM). "We were able to offer him this life-saving device and he was ready to go home within a week."
Aortic valve stenosis is an age-related disease caused by calcium deposits in the valve that cause it to narrow and stiffen. As it becomes harder to pump the blood out to the rest of the body, the heart weakens. Patients experience fainting, chest pain, heart failure, irregular heart rhythms, and cardiac arrest. Without treatment, symptomatic patients usually die within two years. It affects approximately 300,000 Americans.
Many older or sicker patients suffering from aortic valve stenosis are considered poor candidates for conventional surgery, which requires cutting open the chest and temporarily stopping the heart.
"With the aging population, the potential impact of this procedure is enormous," said David Paniagua, M.D., co-director of the Cardiac Catheterization Laboratory at the MEDVAMC and assistant professor of Surgery at BCM. "People can literally gain a new lease on life overnight."
“Before this operation, I couldn’t walk from my garage to the street without having chest pain and difficulty breathing,” said Anderson. “I had to take frequent rest breaks.”
The valve, made of bovine tissue and stainless steel, is about the width of a pencil when it is deployed through a catheter in the femoral artery in the groin. Once it arrives at the correct spot, the valve is released, replacing the diseased one. Patients generally stay in the hospital for an average of three days, compared to seven days with open heart surgery, Paniagua said.
"Surgeons and cardiologists are part of a whole team unified for this one disease process," said Faisal Bakaeen, M.D., chief of Cardiothoracic Surgery at the MEDVAMC and associate professor of Surgery at BCM. "There is very little tissue trauma and in experienced hands, it can take approximately 60 minutes.”
Anderson, with his cheery personality, now leads a very active life with his wife of seven years. They enjoy attending football games in support of their favorite team, the Houston Texans.
“I feel like I am 30 again! All because of the Houston VA, a good cardiologist, and my beautiful wife,” said Anderson, who looks forward to taking an upcoming cruise and spinning his wife on the dance floor.
Besides Bozkurt, Paniagua, and Bakaeen, the MEDVAMC Heart Valve Team is a multidisciplinary team that includes Cardiothoracic Surgeon Loraine Cornwell, M.D.; Cardiologists Blase Carabello, M.D., Biswajit Kar, M.D., Nadir Ali, M.D., Hani Jneid, M.D., Alvin Blaustein, M.D., and Glenn Levine, M.D.; Vascular Surgeons Panagiotis Kougias, M.D. and Carlos Bechara, M.D.; Anesthesiologist Prasad Atluri, M.D.; radiologists; Nursing Coordinator Maryrose Ruma; and other nursing and auxiliary staff. All are specially trained to take care of this unique and complex patient population.
“It was immediately apparent that this VA medical center had the teamwork to make this program work and to be successful,” said Blase A. Carabello, M.D., the Medical Care Line executive and vice chair of the Department of Medicine at BCM. “Everyone from nurses and rehabilitation specialists to imaging technicians and housekeepers focuses on the health and well-being of the patient.”
"This new technology could add years to the lives of our patients," said Samir S. Awad, M.D., Operative Care Line executive at the MEDVAMC and associate professor of Surgery at BCM. "We are proud the Michael E. DeBakey VA Medical Center has some of the best doctors and nurses in the country and offers the latest, minimally invasive alternatives for our Veterans.”