Well Being — 03 February 2017
An alternative treatment for heart disease

By Jana Soeldner Danger

City & Shore Magazine

When an aortic valve deteriorates, it’s bad news for the heart. The valve regulates blood flow from the heart, and when calcification narrows it – a condition known as aortic stenosis – the valve no longer opens fully. The result: Blood flow can be severely impaired, causing symptoms like fainting, shortness of breath and chest pains, which can be precursors of heart attacks.

“The obstruction presents a major burden to the heart,” says
Dr. Robert J. Cubeddu, section head, structural heart disease and director, multidisciplinary valve clinic at Cleveland Clinic Florida. “If left untreated, it carries a bad prognosis.”

Aortic stenosis most often occurs in older people, and in the past, the only method of replacing the valve was open-heart surgery. “In some elderly patients, this presents a huge risk,” Dr. Cubeddu says.

Today, an alternative treatment, Transcatheter Aortic Valve Replacement (TAVR) can provide new hope for these high-risk patients. The minimally invasive procedure works like this: The doctor makes a small incision less than a centimeter in length in the groin, then delivers a replacement valve through a catheter.

The new valve is placed inside the old valve, where it expands and replaces the defective one. There are several advantages to traditional surgery. “We can do TAVR with minimal sedation,” Dr. Cubeddu says. “Patients are kept under observation for one night, and often go home after two or three days. The success rate is greater than 95 percent.”

Because the risks are less than for traditional surgery, it may be appropriate even for very elderly patients. “We’ve done it on 100-year-olds,” Dr. Cubeddu says.

“The most impressive part is the prompt recovery,” Dr. Cubeddu adds. “Within a week they’re back to playing golf, driving and carrying on their daily activities. There are no major restrictions.”

A few words about prevention

While not all heart disease can be prevented, lifestyle changes may go a long way toward helping an individual avoid problems in the first place, says Dr. Enrique Gongora, medical director of the adult cardiac surgical transplant program at Memorial Cardiac and Vascular Institute for Memorial Healthcare System. A diet high in fruits and vegetables, not smoking and getting at least 20 minutes of aerobic exercise every day are building blocks for heart health. “As patients age, they should seek ways to decrease their risks,”
Dr. Gongora says.

It’s also important to make regular visits to a primary care physician for blood pressure, cholesterol and blood-sugar checks. High levels of any of them can put an individual at greater risk for heart attacks.

For someone who does experience a heart attack, Dr. Gongora has one important piece of advice: “Become best buddies with your cardiologist.”

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