When Karl “Ken” Corey was told earlier this year he’d likely need open-heart surgery, he immediately thought he’d be recuperating for weeks, if not months, especially given that he’s 70 years old and had another major surgery last year.
“Having my chest cut open at my age, and having had brain surgery a year ago, I figured I’d be out of commission for a long while,” says Corey, a Putnam resident diagnosed with aortic stenosis, a hardening and narrowing of the aortic valve. But after a minimally invasive surgical procedure, he “was home from the hospital two days after the procedure, on the treadmill in three days and back riding my Harley the day after that,” he says. “I’m going on a motorcycle trip for a few months down the West Coast with my wife Donna, but if I had traditional open-heart surgery, I’d still be recovering instead of taking that trip. Or worse.”
Corey received a transcatheter aortic valve replacement, or TAVR, which repairs a damaged valve by inserting a replacement without removing the damaged one. During TAVR, surgeons insert a catheter into a blood vessel, usually through a small incision in the patient’s leg, then guide it to the heart, where they carefully position the device in the valve and retract the catheter. Not only can TAVR be successfully performed on patients who were deemed too unhealthy for traditional heart surgery, but it can be performed with the heart still beating, and recovery time is, in almost all cases, drastically reduced.
Doctors at the Heart & Vascular Institute at Hartford Hospital were the first in Connecticut to perform the procedure, and to date have performed more than 1,000 of them, mostly on high-risk patients who would not make strong candidates for conventional heart valve replacement surgery. Now, TAVR is being offered to intermediate- and low-risk patients at Hartford Hospital, one of only 35 hospitals nationwide and the only one in New England chosen to perform TAVR on low-risk patients. An estimated 2.5 million people over age 75 have aortic stenosis.
“Without question, TAVR is a major advancement in the treatment of aortic stenosis, allowing a majority of patients with this disease to be treated with a less invasive, catheter-based technique rather than traditional open-heart surgery,” says Dr. Raymond McKay, co-director of the Heart & Vascular Institute structural heart program.
In another pioneering use of the procedure, Hartford Hospital surgeons Dr. Mohiuddin Cheema and Dr. David Underhill were the first in New England to use TAVR to implant a new cardiac valve through the carotid artery in a patient’s neck, avoiding the need to surgically enter the patient’s chest.
“The success of catheter-based techniques to replace diseased aortic valves has fueled ongoing attempts to repair and replace other cardiac valves without traditional open-heart surgery, including the mitral, tricuspid and pulmonic valves,” McKay says.
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