Breathing Better With a New Heart Valve

A minimally invasive procedure has one woman feeling like herself again. The walk to Nancy Fisher’s mailbox is about 100 feet, but it might as well have been a mile. “I had to stop three times to catch my breath,” she recalls. Nancy, now 83, had severe aortic stenosis, a stiffening of one of the valves in her heart. The faulty heart valve wasn’t operating well, preventing the heart from pumping out all the blood that the body needs to function properly. That caused her to feel increasingly breathless and fatigued.

Her cardiologist had been monitoring her heart problem for years. By winter 2020, both her heart function and her symptoms were getting worse. Around this time, Nancy was also diagnosed with breast cancer. She needed a mastectomy, but first her heart valve would have to be fixed.

So in February 2020, Nancy underwent transcatheter aortic valve replacement (TAVR) at Butler Health System. In the hospital after surgery, she immediately noticed a change. “I just couldn’t believe how good I felt,” Nancy says. “They wanted to push me in a wheelchair. I said, ‘I don’t need to go in a wheelchair. I can push a wheelchair.’ So I did.” Nancy felt so good after her heart surgery that she joked about scheduling a tee time at the golf course, her daughter, Kim Hunka, says.

A less-invasive choice

TAVR is a minimally invasive alternative to standard open-heart valve replacement surgery. To perform TAVR, doctors put catheters into an artery in each leg. One catheter carries a collapsible valve on an inflatable balloon. Doctors advance the catheter through the artery up to the heart. Once in place, the balloon is inflated, deploying the new valve and pushing the old valve aside. At this point, the new valve takes over. TAVR is performed with sedation instead of general anesthesia. It requires just two puncture wounds instead of incisions. “Patients are in the hospital for a day or two, and they return to their normal activities within a week or two,” BHS Heart Team says.

Prior to TAVR, a valve replacement patient might stay a week in the hospital and have a six- to eight-week recovery. Nancy went home just 24 hours after her procedure. Her rapid return to feeling good was in sharp contrast to her condition before TAVR. “When we first met Nancy in the clinic, she was really winded, unable to do her activities and very tired,” recalls Marie Delaney, PA-C, the BHS Valve Clinic Coordinator. Fatigue is often one of the earliest signs of aortic stenosis, Delaney says. As it progresses, many people start to notice that they’re breathing a little heavier during routine activities or even while at rest. Other warning signs include chest pain, leg swelling and dizziness. People with aortic stenosis may even pass out.

Experts at performing TAVR

After beginning a TAVR program in 2016, valve specialists at BHS have performed nearly 500 such procedures in a high-tech hybrid operating room.
Patients first undergo a thorough evaluation in the BHS Valve Clinic to make sure they’re candidates, Delaney says. Advanced age is not a disqualifier for the procedure. The oldest TAVR patient at BHS was 96. As for Nancy, she’s looking forward to enjoying more activities now that her cancer and her heart valve problems are behind her. “I give it all to the Lord. Between Him and Butler Hospital and the wonderful doctors and nurses, I’m here today,” Nancy says.