At 74, Diane Witzel was still heading down to the barn every day — tending to the horses, goats, chickens and donkey that she and her husband, Jim, keep on their 10-acre spread in Jackson. Back in March, rotator cuff surgery put a crimp in that routine. Still, Diane’s surgery had gone well, and she was sticking faithfully to her physical therapy program. But at her last session, she wasn’t herself. “I really felt exhausted, so we took it easy,” Diane said. A few days later, she was so short of breath that she asked Jim to call an ambulance.
Damaged Aortic Valve
Diane was taken to St. Joseph’s Hospital where an ultrasound and echocardiogram revealed a narrowing of the aortic valve that reduced blood flow through the body. Left untreated, aortic valve narrowing can cause weakening of the heart muscle and lead to more serious heart conditions. A hallmark of care within the Froedtert & MCW health network, a multidisciplinary team determines a coordinated, comprehensive and personalized treatment plan for each patient.
Diane learned her valve needed to be replaced and that she had two options – traditional open-heart surgery or a minimally invasive procedure called transcatheter aortic valve replacement, or TAVR.”
With the TAVR procedure, a new valve is delivered via a small plastic tube, generally through the femoral artery. TAVR is recommended for patients with severe aortic stenosis who are not ideal candidates for open-heart surgery.
Choosing TAVR at Froedtert Hospital
Diane had bypass surgery a number of years ago, and was, quite naturally, concerned about another cardiac intervention of any sort.
“I wasn’t ready to jump in either direction, but because I was getting short of breath walking from one room to the next, I knew I needed to have my heart repaired,” she said.
After an initial review of the options, Diane met with cardiothoracic surgeon Paul Pearson, MD, PhD, at Froedtert Hospital. Diane ultimately opted for TAVR.
“I participated in a number of clinical trials that demonstrated TAVR valves were safe and better than heart surgery in certain patients,” Dr. Pearson said. He, along with interventional cardiologist Peter Mason, MD, MPH, RPVI, lead the active TAVR Program at Froedtert Hospital.
“TAVR originally was approved by the U.S. Food and Drug Administration in 2011 for inoperable and high-risk patients, but in 2016, it was approved for intermediate-risk patients because the outcomes for TAVR compared to surgery have been favorable,” Dr. Mason said. Having seen this success firsthand in the hundreds of TAVR procedures they have performed, Drs. Pearson and Mason are pleased it is now an option for a broader spectrum of patients.
Procedure and Recovery
With TAVR, the new valve is advanced into position using X-ray and ultrasound guidance. Once in position, the valve is deployed by inflating a balloon that expands the valve frame and pushes aside the diseased valve leaflets. The new valve sits inside the patient’s diseased valve.
“Froedtert Hospital is unique in that, most of the time, we don’t even administer general anesthesia (for TAVR),” Dr. Pearson said. “We just numb the skin where we are going to access the artery in the leg. It takes about 90 minutes from the time patients enter the operating room until the procedure is complete, and most of that is preparation like hooking up monitors and equipment and other preparatory steps. Given the avoidance of general anesthesia, most patients leave the hospital within 24 hours following the TAVR procedure. When patients go home, they can resume their normal activities without needing rehabilitation.”
Looking back at her experience, Diane said she was pleased with the process and the outcome. “Dr. Pearson and Dr. Mason never rushed me, and I had a lot of questions,” she said. “The procedure was everything they said it would be. I felt marvelous immediately after. Within 10 days, I was back out in the barn feeding the animals.”
World-Class Heart Valve Surgery Available Locally
TAVR
