Just five weeks ago, even the simplest tasks proved daunting for Carol Boone. She was weak and couldn't breathe.
"It was very restricting," said Boone of Essex Junction. "I had trouble getting around the house, walking from A to B. I would run out of breath."
That's because her aortic valve was calcified.
"This is a thickened valve that's not opening normally," said Dr. Harry Dauerman, a cardiologist at Fletcher Allen Health Care.
But not anymore. On Feb. 22 at Fletcher Allen Health Care, Boone became the first patient in Vermont to receive a new aortic valve via an experimental method called transcatheter aortic valve implantation or TAVI for short. Right now, most patients get new heart valves made of pig pericardium through open-heart surgery, but not everyone is eligible. It's a major operation.
"There is still a subset of patients who are just too high risk for surgery and where this new procedure comes into play. It offers them a new therapy for their disease process," said Dr. Joe Schmoker, a surgeon at FAHC.
That's because TAVI is much less invasive; no incision in the chest, no heart lung machine. It is similar to a cardiac catheterization where a small incision is placed in the groin and a catheter with the new valve attached is fed through the artery to the heart. Once stabilized, the metal-- similar to a stent-- is deployed. It springs open with the new valve now operating inside the old one.
"So when we see these patients, the breathing tube comes out immediately after the two-hour procedure. They go upstairs; they're sitting upright and talking within hours of the procedure. And when we see them the next day there's some mild groin discomfort they might have, but their breathing is usually the thing that is remarkably improved immediately. So they feel quite well immediately," Dauerman said.
A safer option with an easier recovery for patients who would have died without it. Dauerman says without surgery, more than 80 percent of people with a blockage in their aortic valve will die within three years.
"There are very few procedures more gratifying than this-- to go out to the waiting room and see the families; the strength of the hugs you get tells you that this is something very special to be part of because these patients are literally dying. And to have a technology that can now allow them to live another decade of life without symptoms that would make them bed bound is really pretty incredible," Dauerman said.
"It saved my life and I don't know how you thank someone for saving your life," Boone said.
A high-tech, lifesaving procedure now being studied in Vermont for those heart patients who've run out of options.
Dauerman says the TAVI procedure will be reserved for those patients at highest risk for the traditional open-heart method. He expects to do two to three a month as part of the clinical study.
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