My Mother is Two Weeks Post Aortic Valve Surgery Via the Transcatheter Approach

[Skidude]

Just posting some info about my 84 YO mother's recent AVR via the transcatheter approach which she had at Emory in Atlanta. She got the first generation Edwards Sapien valve catheter delivered valve via her femoral artery. This is a animal pericardial valve attached to a stent which is collapsed down and inserted into a catheter which is snaked up the aorta and then expanded over the old aortic valve.

No chest incision, just the puncture wound on her thigh where the 9 mm catheter was inserted. She was in surgery under general anesthesia for 2 hours, then in the ICU where she woke up about two hours later. They were able to remove her off the ventilator about the time she was waking up, and also removed the pulmonary artery catheter, and she was in the ICU for about 22 hours, and then she went to a regular room. Once in a room she started walking for about 5 - 7 minutes four times a day.

She was released 5 days after surgery and had no limitations except no lifting over 10 lbs for a few days to let her puncture site on her thigh heal. She was put an ACE inhibitor and Plavix + aspirin for 6 months.

As this is currently in a clinical trial and not yet FDA approved, she had to pass the study criteria to be admitted to the trial. If she had not qualified, she was scheduled to get a minimally invasive AVR through the 2nd intercostal space at St Vincents in Birmingham. This is supposed to have a much quicker recovery since the sternum is not cracked, but it is still heart surgery and you're on the bypass machine. From the best I can tell, this is only done in a handful of places in the US.

We are very thankful she was able to have the catheter delivered valve.

Ski Dude

 

[Duffey]

Thank you very much for posting the information about your mom's experience with the transcatheter replacement. I know it is of interest to many of us on VR. Best wishes for a continued good recovery.

 

[Lynlw]

I'm glad your Mother was able to have the percutaneous Valve replacement and glad things are going so well for her. What a huge difference it makes in the recovery.

I think there are about 25 places in the US taking part in the Sapien trials and Medtronic's Corevalve trials will be starting soon, (if they haven't already) and close to 40 centers will be part of those trials. One really good thing about them being done in so many centers is when they are approved, they won't be available only to patients who live close or can travel, compared to alot of things that only a small amount of centers have experience when they are first approved.

 

[Luana]

I had an AVR without a sternotomy; my incision is about 3 inches on the right side of my chest about 3 inches down from my collarbone, and I think it's between the 4th and 5th ribs. Though I don't have anything to compare it to, I think the healing process was quicker and less painful. I was able to drive after 2 weeks and other than some soreness, no real pain, and no run-over-by-a-truck feeling that most people have after the sternum has been cracked. Since I live alone, it gave me a lot more independence in the healing process.

I don't think it's that uncommon, though it seems quite a few surgeons may not be comfortable using the approach. I'm glad I had one who was. I think he was just outstanding.

 

[epstns]

Ski Dude - Thanks for posting this very encouraging result. Many of us have tissue valves and some of us may be needing second replacements when we are up in years, so these studies are especially important to us.

Please keep us posted on mom's progress. Hope she continues to do just fine. (Sounds like she will recover faster than I. . . )

 

[drivetopless]

Thanks for posting. You are first to post with first hand family experience, I think. I'm glad your mother is doing so well. Keep us posted on her progress. Who was the surgeon in Atlanta at Emory?

 

[nngbwh]

Thanks for sharing your story with your mom experience with the transcatheter replacement. That is really amazing !

 

[gail2]

Have there been any estimates or opinions on how long it could take for the FDA to approve the transcatheter approach?

 

[Marcia58]

Ski Dude,

You might want to PM Meredith. She's looking for something like that for her 75yo dad.

 

[scott.eitman]

What great news! Oh to have waited long enought for this kind of technology. I guess your mother did.

 

[Jkm7]

How wonderful to hear your Mom is doing so well.
I greatly appreciate your sharing this information as it is so valuable to so many of us.
Please keep us posted on her progress and send our very best wishes.

 

[ALCapshaw2]

Interesting information. Thank you for posting.

I'm curious about a couple of things.

First, was the valve placed by a Surgeon or a Cardiologist?
The reason I ask is that Interventional Cardiologists perform MANY Catheterizations
while I suspect that most surgeons do not perform this procedure often (if at all).

Second, I'm wondering why you / your mother chose St. Vincents for her minimally invasive option over UAB.

'AL Capshaw'

 

[Lynlw]

Interesting information. Thank you for posting.

I'm curious about a couple of things.

First, was the valve placed by a Surgeon or a Cardiologist?
The reason I ask is that Interventional Cardiologists perform MANY Catheterizations
while I suspect that most surgeons do not perform this procedure often (if at all).

Second, I'm wondering why you / your mother chose St. Vincents for her minimally invasive option over UAB.

'AL Capshaw'

UAB is not part of the PARTNER trials for the Sapien Percutaneous valve .. (I don't think most people consider percutaneous valves min invasive tho) http://clinicaltrials.gov/ct2/show/NCT00530894?term=sapien&rank=1 locations are at the bottom

Actually it doesn't look like UAB is going to be taking part in the Corevalves either

Gail, As when the FDA might approve them, it depends who you are talking to but many of the people involved in the trials believe it will be the end of 2011 or 2012. (and some think it will be years away) There will be a presentation in April at one of the conferences so probably will know alot better idea then.

They HAVE already approved the Melody percutaneous valve for pulmonary replacements