At 81, quality of life is more important than quantity of life for Margaret Zelhart of Plainfield.
Zelhart lives in a ranch home and likes to walk fast. So when Zelhart started having chest pains and shortness of breath simply walking from one chair to the next, she had to address it.
“My [heart] valve was so hindered that to force the blood through it hurt,” Zelhart said.
On Jan. 13, Zelhart became the first person to receive a transcatheter aortic valve replacement (TAVR) procedure in AMITA Health Saint Joseph Medical Center’s new hybrid catheterization lab in Joliet.
Zelhart said she was home 24 hours later. And she feels great.
In fact, Zelhart said the chest pain is gone and so is most of the shortness of breath – unless she “overdoes it,” she said. In fact, she has to remind herself to slow down, and she can’t wait for summer so she can get outside.
“I would like to thank the entire staff at the hospital who played a part in my care,” Zelhart said. “I would like to thank them from the bottom of my heart.”
St. Joes opened the new hybrid catheterization lab on Nov. 18. Dr. Govind Ramadurai, who specializes in interventional cardiology, was part of the cardiovascular team that performed Zelhart’s procedure.
He said the main advantage to the hybrid catheterization lab is that it can quickly be converted into a regular operating room, should the need for one arise during a procedure.
So he’s also thrilled to be able to offer the TAVR procedure in Joliet. He said Joliet area patients previously had to go to Edward Hospital in Naperville if they wanted to have the procedure done locally.
Ramadurai, who’s performed the TAVR procedure for five years, said TAVR is intended for patients who need a heart valve replacement but are considered too high risk for the open heart valve replacement procedure, which is major surgery.
The TAVR is a minimally invasive procedure, he said.
“This procedure is like doing a regular heart angiogram,” Ramadurai said. “You go in from the groin.”
Examples of high risk conditions for open heart surgery might be people over the age of 80 or people with diabetes, congestive heart failure and kidney problems, he said.
For patients under age 70, the risks and benefits of both procedures may be weighed, Ramadurai said.
Ramadurai said Zelhart was examined by two cardiologists prior to receiving the TAVR procedure. Both cardiologists felt she was too high risk for traditional valve replacement surgery, he said.
During the TAVR procedure, a new transcatheter valve is placed inside the patient’s existing valve. In traditional valve replacement surgery, the failed valve is removed, and the new valve is placed, he said.
The procedure takes less than 30 minutes to perform as opposed to the three to four hours needed for open heart surgery, Ramadurai said.
“She spent one night home in the hospital and went home the next day,” Ramadurai said.
By contrast, a person receiving an open valve replacement spends three to seven days in the hospital and complete recovery can take a few months, he said. After having a TAVR, the patient should avoid bending over or lifting heavy objects for seven to 10 days, he said.
“After the first week, there are no restrictions,” Ramadurai said.
So why is this minimally invasive procedure only offered to high risk patients? Couldn’t low risk patients benefit, too?
The issue, for now, is that the long-term data on the longevity of the valves is not there, he said. The valves used in open heart valve replacement can last 15 to 20 years and doctors have 30 to 40 years of data to support that.
The life span of the value used in the TAVR procedure is less certain, he said.
“The minimally invasive valve replacement only started about 10 years ago,” Ramadurai said. “So the data is limited.”