Mary Ellen's Story - Transcatheter Aortic Valve Replacement
Mary Ellen Maneman knew something wasn't quite right. She started falling and was frequently short of breath. But it wasn't until an appointment at The Nebraska Medical Center that she knew just how serious her condition was. "They had me in a wheelchair and they told me to get up to weigh myself," recalls Maneman. "But my heart rate was so low, I couldn't get out of the chair." A heart catheterization revealed the cause of Mary Ellen's troubles: the aortic valve in her heart wasn't functioning properly. As a result, blood flow out of her heart was being obstructed -- a condition that's potentially life threatening left untreated. After a visit to see Michael Moulton, M.D., a cardiothoracic surgeon at The Nebraska Medical Center, the 81-year-old Maneman was left with two options. "Dr. Moulton suggested open heart surgery," said Maneman. "But he also told me about another procedure that didn't involve major surgery. I had to do something, because he said 'Without it, I wouldn't be living long.'" The other, less-invasive procedure is called TAVR, or Transcatheter Aortic Valve Replacement. And it's giving new life to patients like Mary Ellen who could otherwise die without it. "It's a very new procedure," said Moulton. "And it's changing the way we take care of patients with aortic valve disease." Right now, TAVR is only approved for patients who are at high risk for conventional open heart surgery and aortic valve replacement. "The procedure is best for patients who are frail or those who would have a hard time recovering from a standard open heart operation," said Dr. Moulton. "TAVR offers the option of valve replacement with just a small incision in the groin or possibly a small incision in the chest. And it allows patients to recover much more quickly than conventional open heart surgery." The procedure can be done one of two ways. If a patient's femoral arteries in the leg are a suitable size for the procedure, then Dr. Moulton says that would be the first option. If not, a small incision in the chest would be made instead. In Mary Ellen's case, the valve was inserted into her femoral artery via a catheter. That's when the procedure becomes even more high-tech. "Using x-ray and echo guidance right there in the operating room we're able to position the sheath the valve is contained in exactly where we want it," said Moulton. "Then by inflating a balloon that's on a stent, the valve opens up and inside of the stent is the working heart valve." "There really is nothing else like it," says Dr. Moulton. "Patients recover well, they don't have pain in their chest and typically could be in and out of the hospital in two to four days." Mary Ellen couldn't agree more. "I love it," she says. "I would highly recommend it to anyone who needs it. I can walk again and I'm not short of breath. It's really been wonderful. I can go places again and I feel great."