January 21, 2018

Modern Miracles in Medicine

By Bailey McMurdie Parker

 

61 year-old Mark Jamison was lifting a heavy object when he suddenly became short of breath. “I went to my regular doctor and they told me to get checked by a cardiologist,” he recalls. After a few tests, Mark was diagnosed with aortic stenosis—a condition in which the aortic valve of the heart becomes narrow from calcium build-up over time. The calcium deposits harden the valves, making them less mobile. “The aortic valve is arguably the most important valve in the heart,” says cardiologist Dr. Blake Gardner. “It is the final gateway that oxygen rich blood passes through as it leaves the heart and starts its trek to feed vital organs and tissue.” Aortic valve stenosis creates a damming effect of blood flow to the rest of the body. “Most people experience a significant decrease in energy, since there is less oxygen getting to vital organs and tissue,” says Dr. Gardner.

Other symptoms of aortic valve stenosis include lightheadedness, or even fainting. Many people, like Mark, feel short of breath—especially with activity. Another complication of stenosis which arises from the increase in left ventricle pressure is a decrease in blood flow through the vital coronary arteries which lie on the outside of the heart. This can cause chest heaviness or chest pain—similar to when someone is having a heart attack.

 

Up until recently, the only way to replace the aortic valve was to have an open-heart procedure. Open-heart surgery has been the only surgical option for those with aortic stenosis up until recently. Though it remains the best option for some, many advances have been made over the past few years that allow a cardiac surgeon and an interventional cardiologist to replace the aortic valve without having to open up the chest. This new procedure is called transcatheter aortic valve replacement (TAVR). During TAVR, a replacement valve is inserted through a small cut in the artery of the thigh. Doctors use a catheter to navigate the valve up to the heart. The doctor then expands the valve into place and the new valve immediately begins to function.

For Mark, who has issues with wound healing because of his diabetes, open-heart surgery was not ideal. “It was a long process—getting all the approvals for his case. A lot of things had to fall into place for it to happen,” recalls Lori Jamison, Mark’s wife. “It’s like a miracle.” Mark was the first patient at Intermountain Dixie Regional Medical Center to have the procedure. Just a day after, Mark said “I feel like I could get up and walk out of the hospital right now.” He went home just two days after surgery. “As this procedure has been refined, it has allowed patients to get back to life much quicker,” says Dr. Gardner. “Most are walking around just six hours after the procedure, and typically return home within two days.” Prospective patients are evaluated by a team of cardiologists and heart surgeons at Dixie Regional’s Valve Clinic.

 

Though not everyone is a good candidate for TAVR, many are. This is typically determined by a specialized heart team. Overall, TAVR is one of the biggest advancements in healthcare over the past few decades, and is opening the doors for other minimally invasive procedures. People experiencing any of the following symptoms should contact their primary care physician or cardiologist to schedule an evaluation for possible aortic valve stenosis: shortness of breath, fatigue, difficulty walking short distances, lightheadedness, dizziness or fainting, swollen ankles and feet, chest pain, fluttering heart beat, and no longer taking part in activities that used to be enjoyed.

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