June 28, 2012
World War II Veteran Guy Pardue dances with Nursing Coordinator Maryrose Ruma through the halls of the Surgery Clinic at the Michael E. DeBakey VA Medical Center.
PHOTO: Bobbi Gruner
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.
World War II Veteran Guy Pardue, 87, of Bastrop, La. received this transcatheter aortic valve on May 30, 2012. A member of the first Marine platoon to get the M1 rifle, Pardue, who served in the Pacific, landed at Pearl Harbor in Hawaii just days after the surprise attack by the Japanese against the United States naval base. He vividly remembers the nightmarish scene, with bodies of sailors still being pulled from the horribly damaged ships.
"In addition to his advanced age, Mr. Pardue suffers from congestive heart failure, carotid and coronary artery disease, pulmonary hypertension, and atrial flutter," 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 Faisal Bakaeen, M.D., chief of Cardiothoracic Surgery at the MEDVAMC and associate professor of Surgery at BCM. "People can literally gain a new lease on life overnight."
“Before this operation, I couldn’t take a shower without giving out. I could not breathe; just pitiful,” said Pardue. “My doctor at the Monroe VA Clinic shipped me to the Overton Brooks VA Medical Center in Shreveport. After some tests, they said I was in worse shape than they thought and needed to go to Houston in a hurry.”
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, Bakaeen said.
"Surgeons and cardiologists are part of a whole team unified for this one disease process," said Bozkurt. "There is very little tissue trauma and in experienced hands, it can take approximately 60 minutes.”
“Today, I feel renewed. These doctors and nurses gave me my life back – they are the best there is,” said Pardue, who is now looking forward to cooking his famous vegetable soup with okra, growing tomatoes using a secret technique, and maybe, doing some bass fishing.
Besides Bozkurt and Bakaeen, the MEDVAMC Heart Valve Team is a multidisciplinary team that also includes Cardiothoracic Surgeon Loraine Cornwell, M.D.; Cardiologists Biswajit Kar, M.D., David Paniagua, M.D., Hani Jneid, M.D., Alvin Blaustein, M.D., and Glenn Levin, 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.”
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Awarded re-designation for Magnet Recognition for Excellence in Nursing Services in 2008, the Michael E. DeBakey VA Medical Center serves as the primary health care provider for more than 130,000 Veterans in southeast Texas and provides some of the most complex care within the VA Health Care System. The DeBakey VA employs nearly 3,600 staff and is one of 49 institutions within the prestigious Texas Medical Center, one of the largest health and research centers in the world. The DeBakey VA is home to a Post Traumatic Stress Disorder Clinic; Network Polytrauma Center; award-winning Cardiac and General Surgery Program; Liver Transplant Center; Epilepsy and Cancer Centers of Excellence; Substance Abuse Disorder Quality Enhancement Research Initiative; Health Services Research & Development Center of Excellence; Rehabilitation Research of Excellence focusing on mild to moderate traumatic brain injury; Mental Illness Research, Education and Clinical Center; $26.8 million Research and Development Program; and Parkinson’s Disease Research, Education, and Clinical Center. The hospital offers sophisticated, cutting-edge technology such as PET/CT imaging, the Evident™ microwave ablation system, a CyberKnife®, a Varian Trilogy linear accelerator, a Philips Wide Bore Computed Tomography Simulator, the OR•Control System, the Abiomed Impella 2.5 catheter-based heart pump, and the Sapien heart valve. For more than 60 years, the DeBakey VA has served as the primary teaching facility for our major affiliate, Baylor College of Medicine and operates one of the largest VA residency programs in the nation. Each academic year, more than 2,179 students are trained through 194 affiliation agreements with institutions of higher learning. Including the outpatient clinics in Beaumont, Conroe, Galveston, Houston, Lufkin, Richmond, and Texas City, MEDVAMC outpatient clinics logged almost 1.3 million outpatient visits in fiscal year 2011.