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Eighty-eight-year-old Elisa Hollingshead keeps herself busy. She recently took down the curtains in her house, washed them, ironed them and hung them up again, proud of how good they looked and how great she felt, just several months after a heart procedure at Mercy General Hospital.
Hollingshead had been diagnosed several years ago with aortic valve stenosis, a condition that occurs when calcium deposits on the aortic valve cause the valve's flaps to stiffen. As the condition progresses, the valve opening narrows, obstructing blood flow and forcing the heart to pump harder.
At the time, the only way to fix Hollingshead's aortic valve was through open heart surgery, which involves cracking open the chest, something her doctor didn't recommend at her age.
Last December, Hollingshead experienced a life changing moment. She decided to rake the leaves in the front yard of her South Sacramento home after seeing her young neighbor raking his leaves across the street. "I was feeling tired," recalled Hollingshead "Then I suddenly felt light headed and the next thing I remember I was riding in an ambulance to the hospital."
Hollingshead was experiencing symptoms of aortic stenosis including fatigue, fainting upon exertion and shortness of breath. Her doctor mentioned she might be a good candidate for a newly FDA-approved valve replacement procedure called transcatheter aortic valve replacement (TAVR) that was minimally invasive and did not involve open heart surgery. The procedure is currently available for patients considered to be too high-risk for open-heart surgery.
"Symptomatic aortic stenosis not only decreases life expectancy to approximately two to three years, it hampers functional ability," said Kapil Sharma, MD, medical director of advanced aortic and endovascular therapies at Mercy General Hospital, and one of the surgeons who performs the TAVR procedure. "If we can successfully treat these patients with TAVR, it allows them to go on doing the things they enjoy most."
In March, Hollingshead had the TAVR valve procedure. With TAVR, the valve is crimped onto a catheter over a balloon. The catheter (a long, thin, flexible tube), is then inserted through the femoral artery in the groin and tracked to the heart for implantation. When the valve is positioned inside the faulty aortic valve, the balloon is inflated and the valve is precisely positioned.
Doctors say TAVR offers hope to inoperable patients who had no other choice. "Studies show 30 percent of patients with severe aortic stenosis have not been referred for surgical treatment due to advanced age, frailty, or co-morbidities," said Dr. Sharma. "With the introduction of an alternative, less invasive procedure to replace the aortic valve, these patients now have an opportunity to be evaluated and treated. This greatly benefits those who are suffering from heart failure due to their valve and offers them hope for a better quality of life."