Minimally Invasive Surgery Provides Solution for High-Risk Patients

Janice Carlson’s dizziness and constant fatigue limited her enjoyment of life. Called “Mops” by her five children, 14 grandchildren and six great-grandchildren, the resident of Venice, Fla., could not exert herself and had to rest throughout the day.

“I was in a fog and dazed,” she said. “I couldn’t walk straight. Sometimes I was so dizzy I couldn’t get out of bed. I was in bad shape and getting worse.”

(Pictured: Janice Carlson feels “reborn” after her heart valve replacement.)

Her symptoms were caused by aortic stenosis — a narrowing of the aortic valve in the heart. The typical treatment is valve replacement surgery.

But due to other health concerns, Ms. Carlson, 81, was not a candidate for open-heart surgery.

Her cardiologist in Sarasota told her about a new, minimally invasive procedure, called transcatheter aortic valve replacement (TAVR), to replace her damaged valve with an artificial one. A cardiologist friend of Marcia Carlson Pack, Ms. Carlson’s daughter, suggested they seek help at Baptist Hospital of Miami, home of
Baptist Cardiac & Vascular Institute.

Ms. Carlson Pack hit the Internet to do research. She and her mother liked what they read about the experienced Institute specialists. “I wanted the best and I found the very best,” Ms. Carlson said. Institute doctors replaced her faulty valve last September, and her relief was immediate.

“The very next day, it felt like a weight had been lifted from my head. I didn’t have a bit of pain from the procedure,” she said. “It’s like I was reborn.”

The Food and Drug Administration recently approved the procedure for patients who are not well enough for the usual surgical approach. “While traditional valve surgery is still the gold standard of treatment, this is a medical breakthrough,” said Ramon Quesada, M.D., the Institute’s medical director of interventional cardiology and cardiac research. “It gives patients who previously had no options for treatment a chance. Ms. Carlson’s prognosis is excellent, and her quality of life has been drastically improved.”

With the help of a multidisciplinary team that included cardiothoracic surgeons and cardiac anesthesiologists, Dr. Quesada inserted a narrow tube called a catheter in a blood vessel in Ms. Carlson’s groin and threaded it to her heart. The artificial valve was guided to her heart through the catheter. “We replace the aortic valve while the heart is still beating, without surgically opening the chest, stopping the heart and putting a patient on the heart-lung machine,” Dr. Quesada said. The procedure took two hours.

Aortic stenosis affects 1.5 million people in the United States, with 250,000 suffering from severe, potentially fatal narrowing of the valve that causes shortness of breath, chest pain, fainting, fatigue and heart failure.

“Through this procedure, we are working together to help very high-risk patients improve their quality of life,” said Niberto Moreno, M.D., Baptist Health’s chief of cardiothoracic surgery. Ms. Carlson and her daughter were impressed by the skill and compassion of her doctors and the entire hospital staff.

“They work miracles,” said Ms. Carlson, who now walks a mile a day, drives and enjoys outings with friends and family.

“My heart is full of love for Baptist Hospital and all the people there. It was the most uplifting place. I know I’ve been given a real gift, and that’s my life.”