New heart option: MUSC performs minimally invasive surgery on elderly patient
The elderly and other cardiac patients previously considered too sick or frail for open-heart surgery have a new option available to them locally.
Doctors at the Medical University of South Carolina began performing transcatheter aortic valve replacement this spring on patients ineligible for traditional operations.
Soon the minimally invasive procedure could be available to other patients with severe aortic stenosis, or narrowing of the aortic valve.
Aortic stenosis forces the heart to work harder to pump blood, possibly leading to heart failure, blood clots and sudden death. An estimated half-million Americans have the severe form of the condition.
Ladson resident Emma Baker was among them.
The 92-year-old said her heart raced and she became short of breath doing even simple tasks such as walking to her mailbox. Baker’s doctor diagnosed severe aortic stenosis, saying she would die of heart failure if the condition went untreated.
Baker’s age made her ineligible for open-heart surgery, an option she said she would have rejected anyway. Her cardiologist, Dr. Chris Kennedy of Trident Cardiology Associates in Ladson, told her about the new porcedure.
An advisory panel in November 2011 recommended Food and Drug Administration approval for the transcatheter procedure in patients considered high-risk, a wider category that includes patients beyond the frail and elderly.
The panel made that determination after reviewing studies showing no difference in one-year survival rates of patients who had the procedure and those who had open-heart surgery, reports show.
Patients who had the new procedure, however, were more likely to have a stroke following valve replacement than the control group, reports said.
In the new procedure, doctors replace the defective natural valve through an incision in the groin.
They guide the artificial replacement valve — made of cow tissue, polyester and steel — to the heart through the arteries.
Baker, a former school cafeteria worker, had the valve replacement done April 5, and she spent several days in the hospital.
She said her cardiac symptoms have eased since then, and she has few complaints.
“You can’t do what you did when you’re younger, which is frustrating,” Baker said.
Bliss Adams, Baker’s daughter, has noticed improve-ment.
“She could go back to the normal life of a 92-year-old,” Adams said.
Dr. Daniel Steinberg, an interventional cardiologist at MUSC, said the new valve replacement is for patients who have a good quality of life, other than their severe stenosis.
“You do start to wonder when you get to extremes of age if it is too much for the patient and for society,” Steinberg said, noting that costly procedures drive up health care costs. “The real thing we look at is: Does someone truly stand to benefit from fixing their valve?”
MUSC has performed the procedure on seven patients who ranged in age from 79 to 92 since March, Steinberg said earlier this month. He and his colleagues have evaluated more than 60 others, he said.
Reach Renee Dudley at 937-5550 or on Twitter @renee_dudley.