Minimally Invasive Valve Procedure Gets Cedar Rapids Man Back in the Swing
Brian Conway, 63, had been living with a heart murmur for more than a decade. His primary care provider discovered it during a routine checkup, and an echocardiogram revealed the murmur was the result of a heart defect. He was born with a bicuspid aortic valve, which contains only two leaflets, rather than the usual three-flap opening that controls blood flow.
Conway’s primary doctor recommended he see a heart specialist. After researching cardiologists in the area, he says, “I decided for what I was facing, Dr. Kettelkamp was the best choice.”
Richard Kettelkamp, DO, structural cardiologist at UnityPoint Health - St. Luke’s Heart Care Clinic, monitored Conway’s heart health over the next several years. Meanwhile, Conway continued to lead an active life without issues. He's an avid golfer and routinely exercises 45 minutes a day, five days a week. His typical workout includes an elliptical run, along with strength and balance work. However, he said his stamina began to decline.
“I noticed I was having trouble keeping up with my exercise routine,” Conway recalls. “Dr. Kettelkamp watched my heart for well over 10 years with no significant deterioration. Then, in the span of 18 months to two years, it started to fail.”
Cardiologist Recommends New Heart Valve
“Mr. Conway’s bicuspid valve was causing increased turbulent blood flow through the valve, which made it wear out faster,” Dr. Kettelkamp explains. “He was experiencing exertional dyspnea – shortness of breath during exercise – over the last several months. Progressive shortness of breath is a common indicator of a heart valve problem.”
Dr. Kettelkamp recommended Conway have an aortic valve replacement. This can be done through traditional, open heart surgery or via transcatheter aortic valve replacement (TAVR), which does not involve cutting through the sternum. TAVR is performed by delivering a donor-tissue valve, from a cow or pig, through a catheter in the groin. UnityPoint Health - St. Luke’s was the first hospital in Cedar Rapids to offer TAVR and is the only TAVR-certified program in Iowa, as designated by the American College of Cardiology. With such extensive expertise, the team often receives referrals from other hospitals for more complicated cases.
When deciding the most appropriate method for replacing an aortic valve, Dr. Kettelkamp says there are several factors to consider.
“We look at age, surgical risks, other illnesses and previous surgeries, specifically in the chest area, as well as other surgical indications – like if the patient has an arterial blockage or problem with the aorta that needs to be repaired at the same time,” he explains.
“The type of procedure is a shared decision between the patient and a team of doctors and practitioners,” says Katie Maybanks, DNP, who sees patients following structural heart procedures like valve replacement. “We make sure patients are well-informed and know all their options.”
Patient Chooses Catheter-Based Procedure Over Open Heart Surgery
Ultimately, Conway opted to undergo a TAVR procedure. He says he preferred this route because it was less invasive than open heart surgery, and recovery is faster.
“I went to the hospital late morning, was in the operating room about 3 p.m., was out before 4 and was walking by 7 o’clock that night,” Conway shares. “I was home by noon the next day – not even 24 hours later.
“After a week, I was back on the golf course,” he continues. “I’m to where I was before I had the procedure. I’m getting more blood through my body, breathing better, have more stamina and my resting pulse is under 60. I haven’t noticed anything I want to do that I can’t do.”
Signs of Heart Trouble? Doctors Say Don’t Wait
Dr. Kettelkamp and Maybanks say it’s common for patients who’ve undergone valve replacement to report similar improvements, and they advise anyone with a valve issue to have it resolved as soon as possible.
“Often, post-procedure, patients will have more color in their face, more ‘pep in their step,’ or tell us their hands and feet aren’t cold anymore,” Maybanks notes. “That’s because of better circulation.”
“People used to put off valve replacement for as long as possible, because the only option was open heart surgery,” Dr. Kettelkamp says. “Whether someone needs open heart surgery or a procedure like TAVR, it doesn’t make sense to wait to have a valve repaired. Patients recover faster and easier if they’re conditioned when they have the procedure as opposed to waiting until they’re debilitated.”
Common signs of heart valve problems include:
- Chest pain/discomfort
- Fatigue
- Feeling dizzy or light-headed
- Heart murmur
- Heart palpitations
- Shortness of breath
- Swelling in the feet, ankles or legs
“I often hear people blame heart symptoms on age,” Dr. Kettelkamp says. “It’s not fair to dismiss these signs and blame them on getting older. Talk to your doctor. Something is happening that can likely be addressed.”
