Leading the way in heart care: New TAVR procedure offers minimally invasive alternative to open heart surgery

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St. Luke’s TAVR team is the only one in Eastern Iowa performing this life-saving procedure led by Drs. Mark Barnett, Wassef Karrowni and Richard Kettelkamp.

Dean Baughman likes to keep active. Even in his mid-eighties, the Marion man was a regular at the gym. But a bad heart valve left him short of breath and unable to do the activities he enjoyed. It also put him at risk for sudden cardiac death.

Baughman had severe aortic stenosis—a common heart problem in older adults in which a narrowing of the aortic valve restricts blood flow throughout the body. “The standard treatment is open-heart surgery, where we take the old valve out and put a new one in,” explains Dr. Wassef Karrowni, St. Luke’s Heart & Vascular Institute. “But some patients are too sick for major surgery. Today the first choice in treatment for these patients is TAVR.”
TAVR, or transcatheter aortic valve replacement, is a less invasive option for individuals considered high- or medium-risk for open-heart surgery. During TAVR, the replacement valve is inserted via a catheter through an artery in the leg, similar to inserting a stent. Until recently, TAVR was only available in Iowa in Des Moines and Iowa City.

Now St. Luke’s Heart & Vascular Institute has brought this advanced procedure to Eastern Iowa, with support from St. Luke’s Foundation. “Facilities have to meet special requirements to perform TAVR,” says Dr. Karrowni. “We have a qualified multi- disciplinary team trained in the procedure and we perform the required minimum number of cardiac catheterizations and open-heart surgeries. What we lacked was
a hybrid procedure room specially equipped for TAVR. That’s where the Foundation stepped up.”

St. Luke’s Foundation contributed $225,000 to create the facility and purchase necessary equipment. “The dollars came from the Vaughn and Bernice Hartzell Endowment Fund,” explains Foundation President Mary Klinger. “The Hartzells were loyal donors and friends of St. Luke’s Hospital. They created this endowment in 2006 to benefit heart and stroke care.”

The first TAVR procedures at St. Luke’s were performed in October 2016. Dean Baughman was one of those patients. “I had no concerns about the newness of the procedure,” he says. “I thought it was great they offered the procedure right here in Cedar Rapids and I had great care at St. Luke’s.” Today Baughman is back at the gym three days a week, adding, “It feels great to be able to do it again.”

The team at St. Luke’s is performing a growing number of TAVR procedures as more high- and medium-risk patients choose this option. Clinical trials at research centers around the country are evaluating whether low-risk patients might also benefit from TAVR. “If tests prove results are as good for those patients as traditional open-heart, TAVR will become an option for everyone,” notes Dr. Karrowni.
Meanwhile, he says today’s TAVR patients can see the difference in their health right away. “There’s a shorter recovery time than with open-heart surgery, so patients are usually up and walking the same day and go home in two to three days.” Dr. Karrowni adds, “This is a life-saving procedure. Our goal is to prolong life, but also to help you feel better so you can enjoy life, too.”