June 11, 2017
Electrical engineer Richard Fast was one of Medtronic’s first 25 employees and worked on the first pacemaker. Fifty years later, Fast is walking around with one of the latest cardiac innovations in his own chest.
It’s called TAVR, and it saves patients who need a heart valve replaced but wouldn’t survive open-heart surgery. With transcatheter aortic valve replacement, a new valve is inserted by sliding a catheter up through an artery in the leg. It can be done while the patient is awake, and recovery time is typically days rather than weeks or months.
"I had the surgery in the morning and I was walking around the hospital that afternoon," the 83-year-old said. "Went home the next day."
Fast was one of dozens of TAVR patients who gathered Sunday at the University Club in St. Paul to celebrate their new lease on life. The patients all had their procedures done at HealthEast’s St. Joseph’s Hospital, which has not only performed more than 125 of them with a 100 percent success rate but has come up with new uses for TAVR.
For one patient who’d been told that hospice was her only option, Dr. Mudassar Ahmed pulled a MacGyver and combined two devices normally used for other procedures to stop a leak in her tricuspid valve. That was the first of its kind in the Twin Cities – good news for Nancy Munter, because she had the same problem.
"All the time I was growing up as a child, I was always purple," said the now-retired nurse. No one knew she had a heart defect until she was diagnosed in her 30s. She got a new valve from a pig the old-fashioned way, by having her chest cracked open. It lasted from 1979 until last year, when she started feeling really tired and had trouble breathing: "That was a long time to have a little piggy valve in there." But she wasn’t a candidate for open-heart surgery again. Enter TAVR.
St. Joseph’s is also the only hospital in the Twin Cities selected for a clinical trial to test a next-generation TAVR device on younger, healthier patients.
The TAVR procedure is typically done on older patients who are high-risk because of previous open-heart surgery or have other complicating medical issues. For example, Frances Everson, a farmer’s wife and mother of three who had her surgery at 87 and has since had the pleasure of celebrating her 89th birthday.
"When I found out they’d done all that business with just a wire going up my leg, I thought it was crazy," Everson said. "It’s hard to believe."
Now people in their 70s are getting TAVR, and cardiologists are pondering whether it should be the standard even for people in their 50s and 60s who could get open-heart surgery, said Dr. Ahmed, founder of HealthEast’s TAVR program. The clinical trial at St. Joseph’s will help answer that question.
Meanwhile, Richard Fast and his wife, Della, are traveling again – just got back from an extended trip to Branson, Memphis and Nashville.
I’m like a new person. I don’t take naps anymore. I play a lot of golf, two or three times a week," Fast said. He had just one gripe about that TAVR procedure: "It didn’t help my score any."