TAVR procedure at OhioHealth Mansfield allows for faster recovery than open-heart surgery

Of the two heart valve surgeries Janice Smith has had at OhioHealth Mansfield Hospital , the second was much easier for her.

"I had a good experience both times," the 86-year-old said. "It's just that the second time, I didn't really have to take any pain medication."

Smith first had her aortic valve replaced via open-heart surgery in 2011. Then, last year, she had the same valve replaced, except this time doctors made the swap using the transcatheter aortic valve replacement (TAVR) procedure , a less-invasive process where a catheter is fed through an artery in the groin.

"They don't use a lot of the anesthesia with the TAVR because you're not opening a chest," Smith said. "You're going up through the femoral artery."

Surgeon watches TAVR procedure as a precaution

Smith's most recent valve replacement process started when she meet Dr. Yohannes Bayissa and Dr. Atish Mathur, a pair of OhioHealth interventional cardiologists, as well as their entire heart-care team.

They gathered the woman's medical history, then ran a few tests to ensure she would be a good candidate for the procedure.

Patients sometimes are considered too risky for the catheter method of valve replacement and are instead recommended for surgery.

"If it turned out to be open heart surgery, we don't get involved," Bayissa said. "But if the patient is going to be transcatheter, the surgeon will be with us."

Since they are interventionist doctors who specialize in minimally invasive procedures , Bayissa and Mathur always consult with the surgeon who would be called upon to perform open-heart surgery should anything ever go wrong during a TAVR procedure.

"We all sit down," Mathur said. "We as a team discuss them together."

Bayissa and Mathur perform the TAVR procedure as a team. Their roles are interchangeable. They often trade jobs from one procedure to the next.

"It's a two man procedure that needs four hands," Mathur said.

The surgeon is there, watching in case they need to take over and operate on the patient.

"We haven't had anybody go to an operating room in over three years," Mathur said. "Half percent."

'Several advantages of TAVR over open-heart surgery'

There have been more than 300 TAVR procedures completed at OhioHealth Mansfield Hospital.

The operation was pioneered in the 1990s and became common about 14 years ago. The first one in Mansfield was completed in 2020.

"They went through four or five different iterations," Bayissa said. "The technology has never stopped in terms of evolving."

Patients with various sizes of blood vessels have benefited from improvements over the years.

The procedure has progressed to the point where it is open to nearly everyone.

"Now TAVR is considered to be equally first option," Mathur said. "There's several advantages of TAVR over open-heart surgery and in most patients it's considered to be the first line of therapy now."

Despite the advancements, not everyone will make a good candidate for transcatheter valve replacement.

"Some people have certain anatomies that are not suitable for TAVR," Mathur said. "There is still a big role for open-heart surgery, but perhaps as not as it used to be, say five to 10 years ago."

TAVR lets patients recover much more quickly than open-heart surgery

Patients who are facing an aortic-valve replacement can ask their doctor about having the TAVR procedure at OhioHealth Mansfield instead of open-heart surgery.

Like Smith, they may find that option to be much better aligned with their recovery plans.

Superficially, patients can avoid having a scar on their chest because the TAVR procedure uses no knives, only a small entry through the groin area.

"If you have to go through open surgery for a bypass or for a valve or for anything, they really cut through the sternal bone," Mathur said.

That bone has to be wired back together, then given time to heal.

"That healing process for most patients takes months before they are actually able to do things like lift things," Mathur said. "They still feel weak in their chest, especially if somebody is using a walker or something, now that's going to be even harder because they're dependent on their upper body."

Hospital stays are typically reduced from nearly a week with open-heart surgery to overnight with a TAVR procedure.

Smith, who has had both methods, said the minimally invasive TAVR procedure seemed much less concerning than the major heart surgery.

For her, the best part was probably the reduction in anesthesia.

"It was very comfortable," Smith said. "I didn't have a lot of pain or anything."

She remembers the anesthesia disrupted her sleep patterns after the open-heart surgery.

"I didn't sleep that first night," Smith said. "But I didn't have any trouble sleeping after I had the TAVR."

ztuggle@gannett.com

419-564-3508

This article originally appeared on Mansfield News Journal: TAVR procedure at OhioHealth Mansfield allows for faster recovery than open-heart surgery