TAVR is the answer for some high-risk heart valve patients

November 22, 2016 | by Edward-Elmhurst Health
Categories: Healthy Driven Hearts

Leon Lasota has a history of surviving close calls. The 95-year-old Romeoville resident survived an attempt on his life in the late 1930s arising from political conflicts in his native Poland. During World War II he escaped Buchenwald, a Nazi concentration camp, after a three-year imprisonment, and he suffered a gunshot wound while serving in the armed forces.

More recently, in September 2013, Lasota collapsed in his home. His daughter, Sylvia French, was able to cushion his fall, call 9-1-1 and perform CPR.

After a short stay at Edward Hospital, Lasota consulted with two specialists from what is now called the Edward-Elmhurst Health Cardiac Innovations & Structural Heart Center — Mark Goodwin, M.D., System Medical Director of the Center and an independent interventional cardiologist on the medical staffs of Edward and Elmhurst Hospitals, and Bryan Foy, M.D., an independent cardiothoracic surgeon and a member of Edward Hospital's medical staff. The Center uses complex, minimally invasive heart procedures to treat patients who have often been told that traditional surgery is too risky.

After putting Lasota through a series of tests, Dr. Goodwin diagnosed Lasota as having severe aortic stenosis, a narrowing of the valve opening that leads from the body's main artery, the aorta. This makes it difficult for the heart to pump sufficient blood to the rest of the body. Valve replacement through open heart surgery is the treatment of choice, but some patients are considered too high risk for this invasive approach.

Because of Lasota's age and other risk factors, open surgery was ruled out. But, he was a candidate for transcatheter catheter aortic valve replacement (TAVR). Edward-Elmhurst is one of the few providers in Illinois that performs the procedure to treat high-risk patients who can’t have traditional open heart surgery.

"Before TAVR, we’d have to say to these patients, 'You'll want to get your affairs in order.' Now patients who would have faced certain death are having treatment that's highly successful," says Dr. Foy.

On Nov. 14, 2013 at Edward Hospital, a group of about 20, including six physicians, a surgery team and a Cardiac Cath Lab team performed Lasota's three-hour TAVR procedure.

The interventional cardiologists on the team included Dr. Goodwin and Peter Kerwin, M.D. The cardiac surgeons were Dr. Foy and Frank Lutrin, M.D. Another independent cardiologist, Stanley Clark, M.D., monitored echo images throughout the procedure, and Dr. Kerwin inserted a pacemaker. Also on hand was TAVR coordinator, Suzanne Wallace, RN, ACNP-BC.

"Having such a variety of talent and perspective on the team results in the best outcome for the patient,” says Dr. Goodwin. “There are a lot of people in the room but it all goes very smoothly. Everyone knows their role."

To begin the TAVR procedure, Dr. Foy made a small incision in Lasota's chest (in some cases access is through the groin) and inserted a sheath (tube) about the width of a pencil into the heart for transporting instruments.

Dr. Goodwin then performed a valvuloplasty, in which Lasota’s narrowed valve was widened by expanding a balloon attached to a catheter that was sent through the sheath. This set the stage for the Edwards Lifesciences SAPIEN prosthetic heart valve to be delivered, in compressed form, to Lasota's existing valve. The new valve was then expanded, pushing the diseased valve aside. Dr. Lutrin removed the sheath and closed the incision in Lasota’s chest.

"That evening our dad had his breathing tube removed and by the next morning he was up and walking around," says Susan Lasota, Leon’s daughter.

"I was very pleased about the less invasive surgery and felt very comfortable and confident with the doctors,” says Lasota. “My recovery was quick and better than I expected. I no longer have trouble breathing, especially when walking."

Dr. Goodwin says, "You would never believe all Mr. Lasota has been through – even concentration camp – when you see what a joyful, kind person he is."

Learn more about Edward-Elmhurst Health cardiac care.

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