From Press Reports
North Mississippi Medical Center has become the first hospital in Mississippi and west Tennessee to offer a promising new procedure for high-risk patients for whom heart surgery was not an option. Transcatheter aortic valve replacement, which was approved by the U.S. Food and Drug Administration in November, could be a huge breakthrough for high-risk patients who suffer from aortic stenosis, meaning that their aortic valve — the door between the left ventricle and the heart’s main artery — is too narrow to open all the way. Left untreated, a person’s heart could get larger until it has trouble pumping. Fluid could build up in the lungs, and the heart could begin to fail. The heartbeat could become erratic, and the person could suffer a heart attack and die. “Aortic stenosis is similar to having a kink in a water hose,” explained Barry Bertolet, M.D., a cardiologist on the NMMC Heart Institute medical staff. “We have to relieve that kink to keep the water — or in this case, the blood — flowing.” Open heart surgery is usually done to repair or replace severely damaged heart valves, but unfortunately, not everyone is a surgical candidate. Until now, there was little hope for patients like 83-year- old Jimmie Nelms of Columbus, who became the first patient to have the new procedure done at NMMC on Feb. 7. “God opened the door for us, and they’ve given my husband back to me for a long time,” said Bettye, his wife of almost 61 years. “Otherwise, he probably would have been gone before long.” She said her husband is getting around much better these days and plans to resume his aquatic therapy soon. “He’s going to be able to enjoy his grandchildren, great- grandchildren and life in general a lot more now,” Bettye Nelms said. “We’re very grateful.” “I’m very proud that he was courageous enough to do this,” said his daughter, Elizabeth Smith, also of Columbus. “I hope that this will encourage a lot of other people.” The new transcatheter aortic valve replacement manufactured by Edwards Lifesciences allows a team of doctors to replace a diseased valve with no chest incisions. The new procedure is done by a cardiologist and cardiothoracic surgeon together in NMMC’s new hybrid operating room, which is a cross between a cardiac catheterization laboratory and a surgery suite. Through a needle-puncture of the leg, the cardiologist places a catheter (or tube) into the artery of the patient’s leg. A balloon catheter is then placed across the narrowed aortic valve and stretched open so the cardiothoracic surgeon can place the new heart valve. When the balloon is inflated, it pushes the new valve into position and the diseased valve to the side. The balloon catheter is then removed, and the new valve starts working immediately. “Open surgery will still be the treatment of choice for valve replacement,” said cardiothoracic surgeon David Talton, M.D, “but for high-risk patients — those who are older or have other serious health issues — TAVR will be an excellent option to extend life.” Studies have shown that for the first three years after a procedure, the outcome is the same between patients who had open surgery and patients who had TAVR. For more information about TAVR and other procedures offered at NMMC, call 1-800-THE DESK (1-800-843-3375) or visit www.nmhs.net/ heart_institute.