Revolutionary Heart Valve Surgery Performed at Scripps

Retired elementary school teacher Ruth Bradshaw was never the type of person to let anything slow her down. Even at 87 years old, she enjoyed an active lifestyle that included Jazzercise with her friends.

Several years ago, Bradshaw was diagnosed with a serious aortic valve problem. With increasing shortness of breath and multiple fainting episodes, the El Cajon resident was in dire need of heart valve replacement surgery.

Her health history combined with her age made traditional open heart surgery significantly more risky.

Clinical research being performed at Scripps Health shows that deteriorating or clogged heart valves in seriously ill elderly people can be successfully replaced through minimally invasive surgery.

Scripps is one of 26 trial sites around the United States participating in the FDA-approved PARTNER (Placement of AoRtic traNscathetER valves) study.

The trial compares transcatheter aortic valve replacement (tAVR) with traditional open-heart surgery in high-risk patients. The new procedure represents a development whose significance many cardiologists are comparing to balloon angioplasty to clear blocked arteries.

“I believe the transcatheter heart valve will revolutionize heart valve surgery by giving patients who are at high risk for open heart surgery a much less complicated way to replace their diseased and poorly functioning aortic valve,” said Scripps interventional cardiologist Paul Teirstein, MD.

“This new technique has been proven to extend patients’ lives and enhance their day-to-day activities. In my experience, patients feel like they have turned the clock back 10 years.”

New trial results presented on April 3 at a New Orleans meeting of the American College of Cardiology indicate that the procedure is at least as effective as surgery in patients who are not quite so ill, which would extend it to a much larger group of patients.

Cardiologists expect that within a few years, the procedure will be performed on tens of thousands of patients each year. Another trial will soon begin to test the procedure in younger, healthier patients.

Annually, about 200,000 people in the United States need a heart valve replacement, but nearly half of them do not receive one because they’re too sick to tolerate conventional open heart surgery.

In the PARTNER trial, the valve is placed via a catheter inserted through an artery in the patient’s leg or directly through the left ventricle of the heart via a small incision in the chest. These techniques obviate the need for a major open heart surgery.

Dr. Teirstein and cardiothoracic surgeon Scot Brewster, MD, performed Bradshaw’s percutaneous heart valve replacement on March 15 at Scripps Green Hospital.

Using advanced imaging techniques and only small incisions, the physicians guided a small, collapsible heart valve up to Bradshaw’s heart through an artery in her leg. The procedure is similar to what is used routinely to open and reinforce coronary blood vessels.

Within 48 hours, Bradshaw was walking around, eating solid food and feeling “pretty good.” She was discharged from the hospital just three days after her procedure.

Now, just weeks after her heart valve replacement, she is on a speedy road to recovery. Bradshaw said she is “looking forward to Jazzercising, going out to lunch with my friends, and I’m going to start playing golf again.”