It’s been a year of many firsts for the Avera Heart Hospital as the team of experts continue to offer innovative procedures and therapies to patients in the Midwest region. The latest is a minimally invasive procedure for valve replacement, an offering that is potentially life-changing for many seniors with heart disease.
For years, Caren Brown has battled fatigue from a faulty tricuspid valve.
“Well, my legs started hurting, I used to ride a bicycle and my legs started hurting. It was hard for me to keep that bike going,” said Brown.
But with today's appointment, the hope is that her pain and shortness of breath might be a thing of the past. You see, Caren is one of the first in the region to undergo a new valve replacement procedure.
Minimally Invasive Valve Replacement
“EVOQUE is a transcatheter tricuspid valve replacement system where we can fully replace the tricuspid valve through a vein in the leg, the femoral vein,” said John Wagener, MD, FACC, FSCAI, an interventional cardiology specialist with the North Central Heart Institute.
“It's a procedure in which we can replace a valve, not just repair a valve, but replace a valve completely in a patient's heart with a catheter-based procedure and give them a new valve with a recovery time where many patients can go home the next day or several days later,” said Christopher Paa, MD, FACC, a cardiology and cardiovascular disease specialist with North Central Heart Institute.
The issue this procedure corrects is a leaky valve. While medications can treat the symptoms, they can't fix the problem. And before this new tech, an open surgery was not recommended.
"It's a very complex procedure in the sense that it's heavily reliant upon cardiac imaging,” said Dr. Wagener.
"It's really, kind of a coordinated dance between the two of us,” said Dr. Paa.
“So we have our imager, Dr. Paa, who does a transesophageal echocardiogram, and sometimes we use an intracardiac echo so we can visualize the entire valve in a 3D way,” said Dr. Wagener.
“Basically I serve as his eyes, to give him the best images humanly possible so that he can safely get the device up into the patient's heart and then optimally deliver it so that it functions well and that ultimately the patient gets a good and a safe result,” said Dr. Paa.
“So, it's been a little bit different than other valves we treat, but we've seen people, their energy level, their fatigue and their shortness of breath and heart failure significantly improve with fixing the tricuspid valve,” said Dr. Wagener.
For Caren, that means climbing stairs without getting winded and continuing to find more energy.
“It was fantastic. Quality of life does improve and I'm in heart rehab. I want to keep improving!” said Brown.
One of Many First-Offered Therapy Solutions
This new option for valve replacement is just the latest innovative first in the last year at the North Central Heart Institute. Other regional firsts include heart failure regulation, pulse field ablation for heart arrhythmia, as well as a clip device for other valve issues.
“I think it just goes to show how well North Central Heart and the Avera Heart Hospital are able to adapt to new technology and we are adapting new procedures, techniques and therapies constantly. We're still looking to do more with things coming down the road, whether it's through research or things that are commercially available,” said Dr. Wagener.
“And I think what’s really most exciting, is the people who are going to benefit the most are going to be the patients and specifically probably some of our older patients in that they will have technologies available to them and things that can be done for them that will help them that might not have been available in the past,” said Dr. Paa
“It's also the collaborative nature of our surgeons, our imagers, our interventional cardiologists, and all of our support staff from lab techs, nurses and administration, to make sure we're providing the care that we need for our patients,” said Dr. Wagener.
Learn more about cardiac innovation and care available at Avera Heart Hospital
