Thirty-six years ago, surgeons opened Tom Oyama’s chest, stopped his heart and performed two coronary artery bypass grafts while a heart lung machine temporarily kept him alive. He returned home a changed man, working hard to stay healthy through diet and exercise.
As Oyama aged, however, calcium accumulated in his aortic valve. At first, he didn’t notice any of the common symptoms of aortic stenosis. That’s not uncommon. The American Heart Association reports that people often do not experience symptoms, such as breathlessness, chest pain, pressure or tightness, or a decline in activity level, until the blood flow becomes significantly reduced.
Oyama’s second procedure
“Aortic stenosis is a killer,” says Michele Del Vicario, M.D., Oyama’s doctor of 20 years who’s an interventional cardiologist at Providence Little Company of Mary Medical Center Torrance. “Patients with severe aortic stenosis have a 50 percent chance of dying within two years. By putting a new valve in, we expect them to live longer and have a substantially better quality of life.”
After tests revealed that the flow of blood from the left ventricle of Oyama’s heart to the aorta was restricted, Dr. Del Vicario repaired the valve through a minimally invasive procedure. The 87-year-old Oyama left the hospital the next day without pain and feeling like a new man. He was exercising within a week and soon back to his thrice-weekly routine of deep knee bends, sit-ups, weight lifting and half-mile walks at a brisk 3.5 mph clip on the treadmill.
TAVR procedure explained
The procedure—called transcatheter aortic valve replacement, or TAVR—allows doctors to repair a faulty valve without opening the chest. Instead, they work through the femoral artery in the groin or a small incision in the chest, watching their progress via X-rays and echocardiograms.
First they place a collapsible replacement valve through a catheter into the old valve, similar to placing a stent in an artery. Once the new valve is expanded, the old valve is moved out of the way and the new valve takes over the job of regulating blood flow. The U.S. Food and Drug Administration has approved TAVR for people considered high risk—those who are too sick, fragile or weak for open-heart surgery.
Most are in their 70s or 80s. People like Oyama who have had previous valve surgery may also be good candidates for the procedure.
“Success for this procedure has been phenomenal, in my opinion,” says Dr. Del Vicario. “It’s taken five to 10 years to get it to this level. As good as it is, I believe it’s going to get better. Right now there are two valves commercially available. It’s a wide-open field where we’re going to have innovations. These advances will allow us to do more and more of these. Eventually we’ll be doing less open-heart surgery for a growing number of patients.”
The procedure is not without risk. Major stroke, blood leakage back into the heart and other complications, including death are some of the risks. However, Dr. Del Vicario said that today’s technology is significantly safer than even a few years ago.
Fast and successful recovery
Oyama went into the procedure with a matter-of-fact acceptance, faith in himself and a lot of trust in his physicians. His outcome exceeded expectations. The procedure successfully opened the valve, and Oyama was discharged the next day. Even his wife of 63 years, Chic, a retired nurse, was surprised that he was discharged so soon. Most patients are hospitalized from three to five days after undergoing a TAVR.
Before the procedure, Oyama assured his wife, three married daughters and five grandchildren that everything would turn out all right: “Don’t worry about me because I’m in good shape. You’ve got to feel positive about yourself if you want everything to come out okay.”
Dr. Del Vicario is pleased—though not surprised—that Oyama, despite his age and history, feels so good and strong after his TAVR. “He’s had a terrific result,” he says.
If you’re concerned about your heart health, talk to your primary care provider. You can find a Providence provider near you.