Too Risky for Surgery, Houston VA Offers Army Veteran an Alternative
The Michael E. DeBakey VA Medical Center (MEDVAMC) is the first VA to implant an innovative artificial heart valve recently approved for commercial use by the 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. Army Veteran Cottrell McGowan, 81, of Nacogdoches,Tx. received this transcatheter aortic valve on December 21, 2011.
"In addition to his advanced age, Mr. McGowan had chronic lung and renal disease, and a heavily calcified aorta so he was not a candidate for open surgery," said Biswajit Kar, M.D., F.A.C.C., Interventional Cardiology director and an associate professor of Medicine-Cardiology at Baylor College of Medicine (BCM). "We were able to offer him this life-saving device and he was ready to go home two days later."
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 Faisal Bakaeen, M.D., chief of Cardiothoracic Surgery and associate professor of Surgery at BCM. "People can literally gain a new lease on life overnight."
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, Kar said.
"Surgeons and cardiologists are part of a whole team unified for this one disease process," Bakaeen said. "There is very little tissue trauma and in experienced hands, it can take approximately 60 minutes.”
Besides Kar and Bakaeen, the MEDVAMC Heart Valve Team is a multidisciplinary team that includes cardiothoracic surgeons, cardiologists, vascular surgeons, anesthesiologists, radiologists, nursing and auxiliary staff superbly 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 David H. Berger, M.D., M.H.C.M., Operative Care Line executive at the MEDVAMC and 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.”