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Christian Spies, MD, answers questions from the mediaActor and singer Jim Nabors was the fifth of six patients to have a new non-surgical heart valve device implanted at The Queen’s Medical Center. Queen’s cardiologists and cardiothoracic surgeons were the first in Hawai‘i to perform the procedure to treat patients with failing aortic heart valves. The procedure allows patients to be treated without open heart surgery.

Called Transcatheter Aortic Valve Replacement (TAVR), Queen’s is the first and only hospital in Hawai’i to offer the less invasive procedure to inoperable patients with severe, symptomatic aortic stenosis, a serious condition caused by the narrowing of the heart valve. Patients are generally older with multiple medical conditions which can put people at very high risk if traditional open heart surgery is performed. Approximately 200,000 people in the U.S. live with significant aortic stenosis, which often develops into debilitating symptoms that can affect everyday activities such as walking short distances or climbing stairs. Aortic stenosis occurs when the aortic valve does not properly open and close, which restricts blood flow from the heart to the rest of the body. This increases pressure within the heart and causes heart muscles to weaken, and the risk of heart failure is increased. Symptoms of the disease can include extreme fatigue, dizziness, chest pain or pressure, shortness of breath during activity, rapid or irregular heartbeat, and fainting.

 “TAVR is truly transformational as it provides a viable treatment option to patients who could not withstand conventional surgery due to age or serious medical conditions,” said Christian Spies, MD, Medical Director of Structural Heart Interventions, Cardiac Invasive Services and Interventional Cardiologist at The Queen’s Medical Center. “For patients who once had no real treatment option, TAVR is now not only able to extend lives, but also substantially improve quality of life.”

Suffering with aortic stenosis for four years, Nabors was getting progressively weaker, was tired all the time, and was recently spending almost all day in bed. After the procedure, he noticed that his thinking is clearer in addition to feeling much better. “Each procedure went very well,” said Dr. Spies. “Patients were discharged within two to six days post-TAVR.” All six patients were back on their feet and able to walk within one day of the procedure.

Dr. Spies and Jeffrey Lau, MD, Chief of the Department of Cardiovascular Diseases and Cardiothoracic Surgeon, worked with a multidisciplinary team of specialists in performing the TAVR procedure on Nabors on May 29, 2012. “It starts in our Valve Clinic where patients get jointly evaluated by an interventional cardiologist, cardiothoracic surgeon and nurse practitioner,” said Dr. Spies. “Before and after the procedure, we also work collaboratively with other specialists, including cardiac anesthesiologists, non-invasive cardiologists, radiologists, geriatricians, intensivists, nurses, operating room and cardiac catheterization laboratory staff, and other professionals to ensure optimal and comprehensive care of the patient.”

TAVR procedures are performed in Queen’s new, hybrid cardiac catheterization room. The hybrid room combines the latest features of a modern operating room with the technology of a cardiac catheterization laboratory, including three-dimensional imaging capabilities. To perform a TAVR procedure, a catheter is inserted from an incision through the patient’s femoral artery in the thigh. A SAPIEN heart valve from Edwards Lifesciences is attached to the catheter and maneuvered into place over the calcified narrowed leaflets of the patient’s own heart valve. The SAPIEN valve is then deployed by inflating a balloon and begins working immediately, restoring normal blood flow. The heart itself requires no recovery from the procedure, and once the device is deployed, blood flow is unobstructed and the heart’s workload is reduced immediately. The only recovery is from the anesthesia and the incision in the groin.

Currently restricted to only select centers across the U.S., use of the new technology requires a specialized team like the Queen’s Heart team, which has been developed over the past two years. Although TAVR is restricted to inoperable patients, the FDA is considering expanding it to aortic stenosis patients who have a high risk for surgery.

Patients interested in TAVR can be evaluated at the Valve Clinic of The Queen’s Center for Valve and Structural Heart Disease. Patients will be evaluated by a multi-disciplinary team to determine if TAVR is feasible. For more information, call 808.691.8808, email This email address is being protected from spambots. You need JavaScript enabled to view it., or visit www.qhpp.com.

 

Photo captions:

1. Christian Spies, MD, answers questions from the media at a press conference held at Queen’s.

2. Jim Nabors examines a sample SAPIEN heart valve used in his TAVR procedure.

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