At one time, replacing a faulty heart valve meant one thing: open-heart surgery followed by an extended hospital stay and a lengthy recovery.
That’s no longer the case.
Newer technologies have made surgery less invasive and recovery times much shorter. Hundreds of patients have undergone transcatheter aortic valve replacement, or TAVR for short, at CHI St.
Vincent. The minimally invasive procedure enables doctors to replace the aortic valve via a catheter in the leg, in place of open heart surgery.
About two years ago, CHI St. Vincent Hospital was the first hospital in Arkansas to offer the WATCHMAN, an implant that provides an alternative to blood thinners in patients with atrial fibrillation who are at high risk of stroke.
Schevaun Massey, 86, of Hot Springs Village, is alive and well today after undergoing both procedures at CHI St. Vincent.
After several episodes of feeling her heart racing, Massey was diagnosed more than 20 years ago with atrial fibrillation, or AFib for short. It’s the most common heart problem, which can lead to stroke and heart failure if left untreated. The risk of developing it increases with age. In the U.S., 1 in 25 people over the age of 60 have AFib, according to CHI St. Vincent. In the U.S., the disease is more common among white people than among African-Americans or Hispanics, and men are also more likely than women to develop the condition. The World Health Organization has designated AFib as a global epidemic with more than 33 million people globally affected.
Like Massey, many patients with AFib take blood thinners to reduce their chance of developing blood clots, which lead to strokes. But blood thinners can also cause complications.
“I had a couple of intestinal bleeds, and one that was really a granddaddy,” Massey says. “They told me I lost 85 percent of my blood.”
When her cardiologist in Hot Springs Village moved away, Massey sought out Dr. Thomas Wallace, a cardiac electrophysiologist who thought Massey might be a good candidate for the relatively new Watchman. The procedure involves the insertion of a quarter-size device into the left atrial appendage to prevent blood clots from forming.
“The technology has been in development for over a decade,” Wallace says. “The Food and Drug Administration finally approved it for commercial use about two and a half years ago, and we were aggressive in working with the hospital administration to bring it to Arkansas. We were the first in Central Arkansas in perform it.”
Wallace and his partner, Dr. Mangaraju Chakka, implemented CHI St. Vincent’s program which relies on a multi-disciplinary team approach involving cardiologists who specialize in imaging, interventional cardiologists and cardiac surgeons.
“We review the cases and determine what is the right choice for patients in regard to managing their stroke risks,” Wallace says. “Like all new technology, there are scenarios where it is not advisable. Part of the consultation is assessing risk versus benefit.”
During Massey’s evaluation, doctors found that she had severe aortic stenosis, a severe blockage of the aortic valve. The aortic valve has thin leaflets of tissue that open and close as the heart beats to regulate blood flow. When the leaflets become stiff, the valve cannot fully open and close like it should. As the opening becomes smaller, it makes it harder for the heart to pump blood.
The valve had to be fixed before Massey could be considered for the WATCHMAN device.
Wallace sent Massey to Dr. Forrest Glover for the TAVR procedure, which is minimally invasive compared to open heart surgery. Surgeons insert a catheter into the leg in the groin area and then insert a valve to replace the one not working.
In December 2016, Massey underwent the TAVR procedure and was home the next day.
“I don’t recall being limited,” she says. “I was a little tired, but everything was pretty much normal. I had a home health nurse who came and checked on me for a couple of weeks.”
By February 13, 2017, Massey was ready for the WATCHMAN.The procedure involved the insertion of a small umbrella-shaped device into the left atrial appendage where the majority of stroke-causing blood clots form. The procedure takes about an hour and most patient go home the next day.
After her six-week check-up after the procedure, Massey was taken completely off blood thinners and now takes only a baby aspirin daily.
“I’ve had no problems at all, and I feel very fortunate not to have major health problems in my life.” she says. “Anytime you know someone is going to fool around with your heart, it’s worrisome, but I had to have it done. I was a little apprehensive, but I trusted the doctors, and they didn’t fail me.”