TAVR: Extending and Improving the Golden Years
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TAVR: Extending and Improving the Golden Years

Montefiore performed its first transcatheter aortic valve replacement (TAVR) cases in August, giving elderly patients with severe aortic stenosis who were too ill for surgery a chance at a better quality of life.

"We've been recruiting patients since March and have evaluated more than 30 people to date," says David Slovut, MD, PhD, Director, Advanced Interventional Therapy, Montefiore. "Typically these patients are over the age of 80, have significant co-morbidities and are symptomatic—meaning that they are experiencing pain in the chest, shortness of breath or syncope."

During TAVR, a bioprosthetic valve is threaded through the femoral artery via a catheter and into the heart. Once in position, balloon dilation is performed to deploy the replacement valve and its frame within the diseased native aortic valve. The procedure is performed in a hybrid catheterization lab by a collaborative team that includes both interventional cardiologists and cardiac surgeons.

A TAVR valve is deployed via balloon dilation. Image credit: Edwards Lifesciences LLC

A valve is deployed via balloon dilation. Image Credit: Edward Lifesciences LLC

 

Among the first patients treated last summer was 94-year-old James Charlton, a father, grandfather and former professional baseball player in the Negro American League. This one-time athlete explains that his valve disease was severely affecting his quality of life.

"I was constantly short of breath and had a hard time walking," says Charlton, who resides in the Bronx with his wife of 57 years. "Dr. Robert Forman, my cardiologist, referred me to Montefiore as a candidate for the TAVR procedure."

After meeting with Drs. DeRose and Slovut and learning about the risks of TAVR, Charlton admits that he had some reservations.

"When I heard that there was a risk of stroke or death I didn't think I could go through with it," he explains. "But the doctors told me to take my time and not rush my decision."

The following Sunday, Charlton and his wife went to church and prayed with his pastor and another parishioner about the decision. "I couldn't even walk up to the altar because I was so short of breath—so they came to me," he says. "I felt better after this and scheduled my surgery for August."

Charlton, who was Montefiore's first TAVR patient, says that he didn't experience any pain and that the recovery has been great. In fact, he can now move about freely—with the aid of a walker —without feeling winded.

"In my 94 years, I've never been treated as well as I was at Montefiore," he says. "This was the most important moment of my life, and I give the credit to God and Drs. Slovut and DeRose."

"Knowing that there's a chance they can potentially extend their lifespan and live without the limitations of this disease makes a real difference for these individuals," says Joseph DeRose, MD, Chief, Division of Cardiothoracic Surgery and Co-Director, TAVR Program, at Montefiore.

Patients who would like to be considered for TAVR should be referred to Barbara Levine, Clinic Coordinator, at 718-920-6700.