Lutheran Hospital first in region to perform heart valve replacement without general anesthesia

11/20/2017

Lutheran demonstrates leadership in heart care that yields quicker recoveries

FORT WAYNE, Ind. (Tuesday, Nov. 21, 2017) - Lutheran Hospital now offers patients who are unable to endure general anesthesia or surgical procedures a new option for heart valve replacement. The original procedure called transcatheter aortic valve replacement, or TAVR, allows intermediate and high-risk or inoperable patients to receive the life-saving heart valve through a catheter rather than open heart surgery. The new option uses less anesthesia and a percutaneous entry, which eliminates incisions.

Aortic stenosis is the narrowing of the aortic valve. It is one of the most common and most serious valve problems. The aortic valve allows the blood pumped by the left ventricle of the heart to flow to the rest of the body. Severe aortic stenosis prevents normal blood from flowing, thus resulting in symptoms such as chest pain, fatigue, shortness of breath and even fainting.

Benefits of monitored sedation TAVR procedures for the patient include earlier mobility and fewer complications. The noninvasive approach made all the difference for a recent patient, Dennis Coplen, age 68, who received a TAVR on Oct. 25, then a pacemaker on Oct. 27.

"If not treated, Dennis could have died of heart failure within two years," said Mark Meier, M.D., interventional cardiologist, Lutheran Medical Group. "He has had several other complications over the years that now prevent him from having surgery. As the technique has improved over time, it has become an option for some patients. It was definitely a lifesaver for him."

Previously, TAVR was always performed with patients completely under general anesthesia with an endotracheal tube. Monitored anesthesia care is lighter sedation and does not require use of a breathing tube, so patients can talk throughout the procedure.

"When using a monitored anesthesia approach, we work with the cardiologist to use the least amount of sedation possible while maintaining the safety and comfort of the patient," said William Pond, M.D., Associated Anesthesiologists. "Some do quite well with minimal sedation and are aware, and others require more."

Approximately 250,000 U.S. adults experience severe aortic stenosis each year. Nearly 40 percent of those patients are left untreated because they are too high-risk for surgery. Symptomatic severe aortic stenosis is life-threatening with nearly 50 percent of diagnosed patients likely dying within two years if untreated.

Lutheran's structural heart team, which includes interventional cardiologists and cardiothoracic surgeons, takes a rigorous, multidisciplinary approach to patient care to provide appropriate patient selection. When a patient is sent for evaluation, the team will assess the case and work closely with staff to develop the treatment plan best suited to the patient's needs.

A hybrid cath lab, a combination cardiac cath lab and operating suite, delivers high-quality fluoroscopic imaging while also offering the space, lighting and anesthesia capabilities of a full OR. The lab allows an interventional cardiologist and a cardiovascular surgeon to perform collaborative procedures at the same time, such as TAVR, the repair of aneurysms and shunt closure devices, as well as emergent bypass procedures.

For more information about TAVR, call the structural heart clinic at (260) 435-7612, or visit http://www.lutheranhospital.com/tavr.

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