Fantasy To Reality
Doctors had been exploring the concept of using a catheter to replace heart valves since the 1980s, but they had to wait for the technology to catch up. The first successful human implant was performed in 2002 in Rouen, France, and Dr. Babaliaros was the first U.S. physician to travel to France and train under Dr. Alain Cribier, who pioneered TAVR. At that point, in 2004, the procedure had been performed on just 16 patients in the entire world.
It was a precursor of things to come at Emory. The Atlanta hospital has conducted unparalleled research into TAVR, which involves replacing the heart valve via a catheter typically inserted in the femoral artery through a small incision in the groin. In 2007, Emory was one of the principal participants in the first multicenter clinical trial examining TAVR procedures for patients too old or frail to undergo traditional surgery.
Two more trials followed, scrutinizing the procedure first in medium-risk and then low-risk patients, with that latter group receiving the green light to undergo the treatment in 2019.
“These were landmark trials,” says Dr. Babaliaros. “The Emory Structural Heart & Valve Center contributed a lot of patients and lot of expertise to these trials.”
The benefits were clear – at one year, low-risk surgical patients who received TAVR had roughly half the one-year risks of stroke, mortality and rehospitalization compared to those who underwent the much more invasive open-heart route. As opposed to days in the hospital and weeks or months of recovery, patients are eating right after the 45-minute procedure, walking around within hours, and often discharged the following day. Three days after his procedure, John Plageman was back at work.
“My recovery consisted of not lifting anything heavy for a month, and I couldn’t drive for a week,” he says. “That’s incredible. You go through this, and you’re thinking the worst about being in the hospital for two weeks, and I’m out in a day and a half.”
Emory continues to be a TAVR trailblazer through a multi-disciplinary approach to patient care that involves cardiologists, surgeons, imaging specialists and nurse practitioners or physician assistants. Emory has performed more TAVR procedures than any hospital in Georgia, including 650 last year and more than 3,000 since 2007.
“If you can figure out how to do this less invasively, the patients do better,” says Dr. Babaliaros. “In fact, that’s what they want. They want to get the procedure done and get home. Less invasive techniques, robotic techniques, and transcatheter techniques have really taken off as the technology has grown. Now we can do this, whereas before it was all a fantasy.”
Breaking a Barrier
For Plageman, who underwent his procedure in October 2019, TAVR has been the gateway back to a normal quality of life. Looking back, he realizes even his skin had taken on a pallor due to insufficient oxygen flow. He’s able to resume his regular walks, which he had been forced to eliminate due to shortness of breath. He’s looking forward to his annual hunting trip to Wyoming, which he had to cancel last year on the advice of doctors.
Although TAVR is used to repair aortic valves, Dr. Babaliaros says researchers are working on similar approaches for mitral and tricuspid valves, which are trickier, he notes, because of their location between heart chambers that are actively beating. Transcatheter valve replacement has also solved a lot of problems for younger patients with congenital heart disease, specifically pulmonary valve disease.
“TAVR has broken a barrier for us,” says Dr. Babaliaros. Thanks to Emory research, and the research of major academic centers around the U.S., a treatment once reserved for the frail and elderly is now saving and bettering the lives of a much broader patient base. Just ask John Plageman, who’s still amazed he was up and walking the floor with his IV bag just hours after undergoing the procedure.
“The feeling was amazing,” he says. “I couldn’t believe that I’d just had heart surgery.”
Comprehensive Heart and Vascular Care
If you or a loved one has a cardiovascular concern involving the heart, arteries or veins, you will want to consult with doctors who are at the top of their fields – physicians who are sought-after experts, highly skilled, and leading the way to new and better methods of treating heart disease.
Emory Heart & Vascular Center brings together more than 175 physicians, offering comprehensive medical and surgical treatments for the full range of heart and vascular conditions. The Center includes 18 specialized programs in cardiology, cardiac surgery, vascular surgery and cardiovascular imaging.
We see patients at six hospitals with more than 23 community locations. Depending on your need, we can see you as early as the next day.
For more information or to find a provider near you, call 404-778-7777.
