It was a surgery of last resort when the FDA approved a less invasive heart valve replacement that fed a catheter from the groin to the heart so doctors could insert a new valve. Called TAVR, Lee Memorial Health System was first in the state to offer it outside of clinical trials.
“Before TAVR, these patients really had no hope for having this valve replaced,” says Lee Lucas, PhD, clinical researcher with Lee Memorial Health System.
But some people with advanced heart problems weren’t eligible because they had clogged arteries.
“So we couldn’t actually get the catheter all the way up there because of their peripheral vascular disease,” says Dr. Lucas.
Now an advanced approach is proving there’s more than one way to a person’s heart. A new, transapical entry that punches directly through the chest wall is allowing more people to get in on this surgery.
“Being able to approach it through the chest wall has opened it up to patients who before were excluded because of severe vascular disease and obstruction in the veins that wouldn’t allow these big catheters to be placed up their arteries,” says Dr. Brian Hummel, cardiothoracic surgeon with the Lee Memorial Health System medical staff.
Instead of threading a catheter through the body, surgeons are taking a direct approach.
“We’re creating a tiny hole, perhaps an inch and a half long, in the chest wall and then we place sutures around in the heart muscle itself and poke a hole into the heart,” says Dr. Hummel.
The chest entry allows more precision than working with a long catheter.
“This is a much shorter device and we have direct control. We can move it in and out a little bit within a millimeter of where we want it to be,” says Dr. Hummel.
Both procedures are opening up options that were previously unavailable to severely ill heart patients.