New procedure lets high-risk patients avoid surgery



After undergoing a transcatheter aortic valve replacement (TAVR) in November 2014, Spike Moffatt of Milford is "doing phenomenally."

After undergoing a transcatheter aortic valve replacement (TAVR) in November 2014, Spike Moffatt of Milford is “doing phenomenally.”

“The Lord will either take me home or keep me here to talk to people and share my story,” Horace “Spike” Moffatt told his wife, Sharon, before undergoing a relatively new procedure to replace the faulty aortic valve in his heart.

That was last April.

Now, at 84, the Milford man not only is still here, “He is doing phenomenally,” Sharon Moffatt said.

The opening in her husband’s heart valve had become so narrow that it was restricting the flow of blood from his heart to the aorta and out to the rest of his body. The condition is not uncommon in people in their 70s and older.

Spike has always been active and vigorous, but he’s also had a weakness for foods that weren’t all that good for him, especially his heart, Sharon said.

“I used to call him a junk food junkie because he was always into the sweets and potato chips and things like that.”

Spike has had several stents placed in blocked coronary arteries to keep the blood flowing.

“But every time he left the hospital, the first thing he wanted to do was go and get a lobster roll that was filled with mayonnaise,” Sharon said. “That wasn’t good.”

Spike was diagnosed with a defective heart valve last spring after he started having symptoms he couldn’t ignore. He was very short of breath. He occasionally lost his balance. And he had some chest pain.

His cardiologist, Dr. Matt McKay at Eastern Maine Medical Center (EMMC) in Bangor, determined the symptoms were caused by a poorly functioning heart valve that needed to be replaced.

Ever since valve replacement surgery was first done in the 1950s, it has involved opening the chest and cutting into the heart. But for people who have serious heart or lung disease, open heart surgery can be extremely dangerous.

Fortunately for Spike Moffatt, McKay had begun performing a minimally invasive alternative procedure in November 2014. The procedure is called transcatheter aortic valve replacement (TAVR).

With TAVR, a catheter is inserted into an artery, usually in the groin, and snaked up into the heart. On the end of the catheter is a tiny balloon with the replacement valve crimped down around it, sort of like a closed umbrella. Once the new valve is positioned inside the old, worn out one, the balloon is inflated and the new valve opens, restoring normal blood flow.

Replacement valves are made from the lining of a cow’s heart.

“I used to call him a junk food junkie because he was always into the sweets and potato chips and things like that.” — Sharon Moffatt

“I used to call him a junk food junkie because he was always into the sweets and potato chips and things like that.” — Sharon Moffatt

Because the TAVR procedure is far less invasive than open heart surgery, recovery is typically much faster.

“Some people have almost instant relief of symptoms,” said Ann Johansen, clinical coordinator for the Valve Center at EMMC. “Others, because they are so de-conditioned, might take two or three weeks to start feeling better.”

Patients who have open heart surgery are often in the hospital five to seven days. With most TAVR patients, it’s two or three days.

But the good results so far don’t necessarily mean that TAVR will become the preferred method of valve replacement for all patients or even for those with relatively serious heart disease. After all, the first TAVR procedure was done barely a decade ago, so the jury is still out on how effective and safe it is in the long run.

“We do our surgeries based on clinical research, and there’s still quite a bit we don’t know about the durability of this valve and possible long-range complications,” Johansen said.

But she said TAVR technology is advancing every day.

“It’s all about improving somebody’s quality of life,” she said. “We’re looking to take someone who is symptomatic, who can’t do the things they want to do, and turn them around so they can be physically active and get that enjoyment back.”

Cardiologist Dr. Matt McKay performs TAVR at EMMC, one of three facilities in Maine that offers the relatively new procedure.

Cardiologist Dr. Matt McKay performs TAVR at EMMC, one of three facilities in Maine that offers the relatively new procedure.

It certainly worked for Spike Moffatt.

When he left the hospital after getting his new heart valve, he spent two weeks recovering and regaining his strength at Stillwater Health Care, a rehabilitation, skilled nursing and long-term nursing facility in Bangor that is affiliated with EMMC.

The Moffatts were so grateful for the care Spike received that they wanted to give something back. Their home in Milford is just a few miles from Stillwater Health Care, so they began volunteering there several days a week.

“We’ve been here ever since,” Sharon said recently.

“Spike loves doing the volunteer work. He pushes people around in their wheelchairs, taking them to their rooms and out for activities. We sing songs to them. We do anything and everything they need us to do here.”

The TAVR procedure is now performed at three hospitals in Maine: EMMC, Maine Medical Center in Portland and Central Maine Medical Center in Lewiston.

 

Dick Broom

Dick Broom

Reporter at Mount Desert Islander
Dick Broom covers the towns of Mount Desert and Southwest Harbor, Mount Desert Island High School and the school system board and superintendent's office. He enjoys hiking with his golden retriever and finding new places for her to swim. [email protected]
Dick Broom

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