Harold Klinsky, 89, had a quadruple bypass surgery at St. Luke’s 14 years ago. The Hiawatha man remembers his long recovery. So, when doctors told him several years later that might need to have open-heart surgery once again – this time to fix his aortic valve, which was starting to close. He wasn’t anxious to repeat the surgery.
“I was told I had aortic stenosis,” shares Klinsky. “It was causing my aortic valve to close over time. Every year my cardiologist would run tests to monitor my valve. Several years had passed since it was first mentioned to me, but it wasn’t an urgent problem initially. So, in the meantime I started doing some research and learned about a procedure called TAVR, which wouldn’t require open heart surgery. When St. Luke’s started offering TAVR
a couple of years ago I was pleased I could have it close to home.”
Transcatheter Aortic Valve Replacement
TAVR stands for transcatheter aortic valve replacement. UnityPoint Health – Cedar Rapids Heart and Vascular Institute began its TAVR program late 2016. Since then doctors have performed 129 procedures to date. TAVR is best suited for individuals with moderate to high risk aortic stenosis (failing heart valves), that are not candidates for surgical valve replacement. TAVR valves are inserted via a catheter typically through the femoral artery, without open-heart surgery. This minimally invasive surgical procedure repairs the damaged valve by placing a replacement valve into the aortic valve.
“Aortic stenosis is slow progressing,” explains Richard Kettelkamp, DO, UnityPoint Health – St. Luke’s Cardiology Clinic.
“There are some people who are predisposed to aortic valve stenosis but in most cases it's just a product of wear and tear on the valve, which happens over time. It tends to happen in patients as they get older and a lot of our patients are in their 80s and 90s - there are some younger, but the majority are elderly.”
“I started to experience chest tightness and discomfort,” shares Klinsky. “I was even feeling light-headed at times and my doctor said it was time to do something about my aortic valve. I went ahead and had the procedure in February 2017. It was a simple procedure. All I had was a small incision and that’s it. It’s amazing. You don’t have any pain. I have not been sorry I had the TAVR procedure.”
“Symptomatic aortic valve stenosis is a bad thing,” says Dr. Kettelkamp. “When a person develops symptomatic aortic valve stenosis their two-year mortality is 50 percent. It's a very serious medical problem. Once you develop symptoms you need to act quickly. It's time to do something about it because time is of the essence. With this particular set of patients who are high risk for open heart surgery - their prognosis is about 50 percent at one year - so it's even more critical.”
“We want to see patients before their condition worsens,” explains Katie Maybanks, Structural Heart and Valve Program nurse practitioner at UnityPoint Health – St. Luke’s Cardiology Clinic. “We would like to see them with either no symptoms or mild symptoms because their outcome will be so much better. That’s why routine physicals and tests with their family doctor or cardiologist are important to spot these issues early.”
According to Maybanks patients from Iowa and Illinois have had their TAVR at St. Luke’s. The TAVR team collaborates with the patient’s cardiologist during the full continuum of care.
“The program is going well,” says Dr. Kettelkamp. “We’ve hit our stride. There are a lot of team members involved to make these procedures successful and we work well together. This program is a perfect example of what the Heart and Vascular Institute offers - lots of different heart specialists - providing expertise that allow us to offer these new procedures. There are many areas of growth that we anticipate in the days ahead for the structural heart program.”
As for Klinsky – he was happy TAVR was offered at St. Luke’s. He stayed one night at in the hospital and had no restrictions following his procedure. He noticed an improvement in how he was feeling immediately.
“It was sure a lot different from when they opened me up for heart bypass surgery many years ago,” says Klinsky. “It was worth it. If you are hesitant I would say go for it.”
If you have aortic valve stenosis and believe you may benefit from TAVR, please call UnityPoint Health - Cedar Rapids Heart and Vascular Institute at (319) 739-2036.