Heart Surgery of the Future
Saint Barnabas Medical Center’s first “half-day TAVR” patient is feeling great after his minimally-invasive transcatheter aortic valve replacement procedure.
Open-heart surgery was a big ordeal—this standard of care performed by doctors for more than 50 years would require a week’s hospital stay, followed by a recovery period that could last up to two months. But thanks to new technologies developed over the past few years and what is being dubbed as a “paradigm shift” in the field, doctors have been performing a relatively new procedure called TAVR, or transcatheter aortic valve replacement, to replace a narrowing valve in patients diagnosed with aortic stenosis. “It’s a minimally-invasive, catheterization-based procedure where the new valve is inserted through the groin,” says Sabino Torre, M.D., co-director of interventional cardiology at Saint Barnabas Medical Center (SBMC).
And though RWJBarnabas Health performs more TAVR procedures than any other health system in New Jersey, SBMC recently treated its first “half-day TAVR” patient, who had the procedure and was discharged from the hospital within a matter of hours.
This patient is 69-year-old Paul Russo of South Orange, who initially complained to his internist, Debra Goldson-Prophete, M.D., of shortness of breath and fatigue. After running tests on Russo, Dr. Goldson discovered he had a heart murmur and then referred him to Dr. Torre, who found the same murmur, performed an echocardiogram (echo) and diagnosed Russo with a narrowing of the heart valve.
Mr. Russo was considered low-risk due to his age, so the heart team knew he would be a perfect candidate for TAVR rather than require surgery. So, about a month later, in January 2021, Dr. Torre, along with cardiac surgeon Arash Salemi, M.D., and Elie Chakhtoura, M.D., interventional cardiologist, performed the TAVR on Russo with no complications.
“I went in on a Monday morning and I was released Monday night,” Russo says. “Dr. Torre came in and checked me and said, ‘You’re doing great.’ I was walking around the hospital floor and he told me he could send me home. I had no pain and everything went perfectly.”
Dr. Torre says the average length of stay for TAVR is a day and a half, and that despite some soreness at the puncture site, patients are back to their regular activities by the following day. But Russo was discharged after just a few hours because he had no trouble getting out of bed, was not bleeding from the groin area where the catheter was inserted and his vitals and EKG were stable. Says the doctor, “he was up and at ’em the next day.”
Dr. Torre and the heart team at SBMC are working to streamline the minimalist approach to this procedure so other patients can have similarly positive experiences. “That’s the standard and that’s the goal,” he says, “to make this procedure a same-day or ‘half-day’ TAVR in some patients.”
In addition to a quick and easy recovery immediately afterward, Russo is doing great a few months later. “I’m feeling a lot better and I don’t get out of breath anymore when I walk up and down stairs,” he says. “I’m glad I got the TAVR done at SBMC and that they caught [the narrowing valve] in time.” Russo has had two follow-up appointments since January, at which he got an EKG and an echo. He’ll return to the clinic in a year for another echo.
“The ideal valve and delivery system and technique is still in progress, but TAVR has come a long way,” Dr. Torre concludes. “This is a big area of growth in terms of taking care of patients without surgery in the future.”
To learn more about Dr. Torre, an RWJBarnabas Health Medical Group provider, and the heart team at Saint Barnabas Medical Center, call 973.322.2200.