Some of Covenant Health's TAVR patients during the health system's first year of offering the procedure.

TAVR - Charting New Directions in Heart Care

It was a virtual replay – cardiothoracic surgeon Dr. Chadwick Stouffer did the cutting and Roy Ogle was on the receiving end. But this time it was a piece of cake – literally – as Parkwest Medical Center celebrated the one-year anniversary of its first transcatheter aortic valve replacement (TAVR) procedure. Parkwest is the first hospital in the area to offer TAVR as a minimally invasive procedure to help men and women with the progressive, life-threatening condition known as aortic stenosis.

The celebration, featuring a cake emblazoned “TAVR Changing Lives,” was in honor of all the TAVR patients and in recognition of Ogle’s progress since becoming the first to undergo the procedure in June 2012.

In the year since, the multi-disciplinary TAVR team of physicians from Parkwest and Fort Sanders Regional Medical Center, including cardiothoracic surgeons Dr. Stouffer and Dr. Thomas Pollard, interventional cardiologists Drs. Mike Ayres and Nicholaos Xenopoulos, and cardiac anesthesiologist Dr. Lee Collins, offered hope to nearly 60 more men and women who were deemed inoperable for traditional open-heart surgery and had run out of options. The patients received new their new heart valves via a catheter tube inserted either into the femoral artery or through the rib cage. Recovery is markedly shorter than traditional open-heart surgery.

The youngest TAVR patient was 62 and the oldest 96; average age was 81. In most cases the patients were discharged from the hospital within three to six days.

“It has been an amazing journey,” said Sheilah Vartan, the nurse navigator who works closely with the TAVR team. “To see patients after surgery brings a lot of joy to all members of the TAVR team. The difference in their quality of life is often profound. The families of the patients actually experience activities with them that they have not been able to enjoy together in years.”

An important aspect of TAVR is its multi-disciplinary approach. In addition to the TAVR physicians specializing in cardiovascular and cardiothoracic surgery, interventional cardiology, and cardiac anesthesiology, the team includes nurses and technicians with specialized training.

“A successful TAVR requires precise, simultaneous execution of a set of tasks,” said Dr. Thomas Pollard, cardiovascular surgeon. “The skill set required to perform these tasks crosses multiple medical and surgical specialties.”

The operating room used for TAVR procedures is also multi-disciplinary in design. A $2.6 million hybrid operating room at Parkwest combines the resources of a cardiac catheterization lab and an operating room, including the imaging equipment needed for minimally invasive procedures.

Dr. Stouffer believes the TAVR work is laying a foundation for treating other heart problems. “Certainly as the technology advances, I expect we will be able to apply similar techniques to other failing heart valves. . . the multi-disciplinary approach to our patients will serve as a model for treating many patients with other complex cardiac diseases.”