Health & Fitness

Treating faulty heart valves without major surgery

Margit Cooper works in her yard Sunday, not long after having a transcatheter aortic valve replacement at the University of Miami Health System.
Margit Cooper works in her yard Sunday, not long after having a transcatheter aortic valve replacement at the University of Miami Health System. Miami Herald Staff

Open-heart surgery was no longer an option for Margit Cooper, who was 88 when she had aortic valve-replacement surgery.

Cooper, now 89, experienced shortness of breath, chest pain and exhaustion that got more severe overfive years.

Had her valve replacement, which was performed through a catheter, not been an option, her quality of life would have continued deteriorating. Already, Cooper had to cut back on her gardening and walks.

Dr. Mauricio Cohen, director of the cardiac catheterization lab at the University of Miami Health System, performs TAVR, or transcatheter aortic valve replacements, on high-risk patients.

TAVR replaces failing aortic valves in patients who are not good surgical candidates by threading a catheter through the groin and up to the heart. Cohen performed the procedure on Cooper.

“Margit had very severe aortic stenosis. Her valve was so tight that her heart could barely pump enough blood to her body,” Cohen said.

“What if I keep going like I’m going?” she said of her condition at the time. “I could have had multiple heart attacks.”

Now, about a year after her surgery, Cooper is back in her garden, full of papayas, figs, tomatoes, vegetables and flowers. “I try to grow whatever grows naturally,” she said. “I didn’t know I was going to live that long.”

TAVR is often the only option for high-risk patients, a group that includes the elderly. About 5 million Americans are diagnosed with valve disease each year, according to the American Heart Association.

Out of the heart’s four valves, the aortic and mitral valves are the ones most operated on. The aortic controls blood flow out of the ventricles; the mitral controls blood flow from the atria, one of two blood collection chambers in the upper part of the heart, to the ventricles.

Valves can be leaky or blocked, said Dr. Niberto Moreno, a cardiac surgeon with Miami Cardiac & Vascular Institute at Baptist Health South Florida.

When the four valves are working property, the tissue flaps open and closed with each heartbeat. That allows blood to flow through the heart’s chambers and to the rest of the body.

Heart valve disease occurs when the valves fail to work property, which forces the heart to work harder to pump blood. That can lead to shortness of breath, palpitations and severe fatigue.

Valve disease can be the result of age or a genetic condition. Moreno said treatment ranges from open-heart surgery to less-invasive procedures like TAVR.

Gloria Potter, 83, recently had an aortic valve replacement. About 13 years ago, she had an angioplasty, which surgically repairs or unblocks a blood vessel. Potter was otherwise in good health.

Potter said her doctors followed her carefully over the last few years, and while she felt some fatigue, she did not have a heart murmur, a common symptom of heart valve disease.

According to the American Heart Association, some patients have no symptoms, some develop noticeable symptoms very quickly, and for some, the symptoms are gradual.

Three days following her valve replacement, “I was walking around and feeling great,” she said.

While Cooper and Potter had successful experiences with valve replacement surgery, Moreno warned that the risks associated with surgery still apply, and that recovery takes about a month with open-heart surgery.

“All of the complications that occur with other surgery, occur with all three — medical therapy, surgical therapy and percutaneous therapy [a procedure performed through the skin],” he said. “You want to catch patients before they become symptomatic.”