A New Valve, No Inclusion: A New Lease on Life


Last year, the retired schoolteacher’s aortic valve became so narrowed, that Barbara Keene would become profoundly short of breath with walking and would pass out frequently.

Without a valve replacement, Keene’s heart would give out within two years. But the Huntington Beach great-grandmother had undergone open-heart surgery a few years ago, making a second open heart surgery too risky.

Lucky for Keene, there is Hoag.

For the first time in Orange County, patients who are high risk or too ill to undergo a lifesaving heart valve replacement surgery have a completely non-surgical, life-changing option.

The Jeffrey M. Carlton Heart & Vascular Institute at Hoag now offers a percutaneous Transcatheter Aortic Valve Replacement (TAVR), a new and innovative approach to aortic valve replacement, in which the new valve is advanced through a small puncture site in the groin, navigated through the aorta and deployed across the aortic valve.

“I don’t pass out any more,” Keene said. “I can go up and down stairs now. It is a slow process, but I am getting better.”

This new procedure serves as a complement for an innovation adopted three years ago at Hoag that utilized a minimally invasive surgery to perform TAVR. That surgery required a tiny incision and was associated with a four-day hospital stay. The newer technology, by contrast, allows patients to receive their heart valve without any incision and return to their lives in as short as 48 hours. It is reserved for those patients for whom even minimally invasive surgery is considered too risky.

“My heart was too fragile to risk another open heart surgery. This was ever so much easier,” Keene said. “I had my (procedure) on a Wednesday and I came back home on a Friday. I think it’s fascinating how they were able to do this. I am so grateful.”

More than 1.5 million people in the U.S. suffer from aortic stenosis that can progress to restrict every day activities, including walking short distances. Replacing ailing valves gives these patients their life back – but a third of them, like Keene, are deemed inoperable or high surgical risk, either because they are too elderly, too ill or have another medical problem that makes open heart surgery too risky.

Without an operation, approximately 75% of people with severe, symptomatic aortic stenosis die within two years. Hoag is one of a handful of hospitals around the state and the only one in Orange County approved to perform TAVR. And now, with the new non-surgical approach, the hope is to give a new lease on life to more people than ever.

“The newer technology is a tremendous advancement over the earlier versions, which means more people can benefit from this life-changing procedure,” said Aidan A. Raney, M.D., Director, Cardiac Surgery and James & Pamela Muzzy Endowed Chair in Cardiovascular Surgery. “This commitment to incorporating the most innovative technology available is one reason Hoag cardiac patients achieve some of the highest clinical outcomes in the nation. It is our constant goal to give patients greater access to safer, more advanced cardiovascular care.”

Hoag performs more heart valve repairs than 90 percent of all cardiac programs in the nation, including minimally invasive robotic valve replacement surgeries, and has the highest volume valve program in the county. This expertise translates into a skill level that exceeds most programs.

“They took such good care of her,” said Shirley Allen, Keene’s daughter. “Everyone, the doctors, the nursing staff, they were just wonderful.”