Not Your Father's Heart Valve Surgery

Published in Greater Washington Area - Spring/Summer 2022

Bill Craig vividly remembers his father having open-heart surgery to replace a faulty valve between his heart and his aorta, known as the aortic valve, more than 20 years ago. That experience was at the top of his mind when his cardiologist told him it was time for him to have an aortic valve replacement to correct his own heart issues. He worried about the possibility of a long and difficult recovery, like his dad.

But a lot has changed when it comes to aortic valve replacements since Craig’s father’s surgery.

Craig’s cardiologist thought he might be a candidate for a different kind of aortic valve replacement procedure called transcatheter aortic valve replacement (TAVR). The cardiologist referred him to Rani Hasan, M.D., M.H.S., regional medical director of the Johns Hopkins Medicine Structural Heart Disease Program at Suburban Hospital.

Transcatheter aortic valve replacement is a minimally invasive procedure where the replacement aortic valve is delivered by a catheter inserted through a small incision, most often in the patient’s groin. The catheter is threaded through the arteries to the failing valve, where it places the replacement valve inside the failing one. The new valve pushes the old valve aside and takes over its work controlling blood flow out of the heart. Unlike open-heart surgery, patients who undergo TAVR can often go home after one night in the hospital and return to activities gradually after one week.

A former resident of the Bethesda, Maryland, area, Craig, who now resides in Frederick, Maryland, knew Suburban Hospital and his family had received care there for other conditions. But he wasn’t aware of Suburban’s facilities and expertise in advanced coronary artery procedures. “I never put them on the same level as Johns Hopkins Hospital for this kind of care until I heard about Dr. Hasan and the Structural Heart Program,” he says.

Before meeting with the structural heart team, Craig Googled TAVR and Dr. Hasan, then watched Dr. Hasan’s YouTube videos explaining the program. As Craig quickly learned, Dr. Hasan is one of the region’s leading experts when it comes to TAVR and has performed more than 400 TAVR procedures.

His first meeting with the team was all it took to convince Craig that Suburban was the place for his valve replacement.

“Ordinarily when you go to see a surgeon, they are so focused on the item they have to fix,” he says. “But I immediately met Crystal (the program’s nurse practitioner/care coordinator), then Dr. Hasan and Dr. Matthew (director of cardiac surgery at Suburban). They were phenomenal and took all my fear and trepidation away. I left that day feeling like they had a sense of, ‘We know what we’re doing, and we know how to fix you.’”

At Suburban, both interventional cardiology and cardiac surgeons – the physicians who perform open-heart surgical valve replacements – meet with every patient who needs a valve replacement and work together to determine the best approach for each individual. It may be a minimally invasive TAVR or it may be open-heart surgical aortic valve replacement, referred to as SAVR.

“Generally, we take the approach of thinking about the lifetime management of a patient’s aortic valve,” says Dr. Hasan. “We consider their age, health, the number of valve replacements they may need down the road, and whether their coronary arteries and the structures of the heart will work for a catheter-based procedure. It’s a very individualized process.”

Whether TAVR or SAVR is recommended, each patient completes a thorough evaluation and preparations to provide the team all the information they need to successfully replace the valve.

“The team helped the process keep moving forward from my first meeting in January to my TAVR in March,” says Mr. Craig. “They were easy to communicate with and quick to respond at every step. I found a level of comfort and calm early on in the process, knowing I wasn’t going to have to go through the same procedure my father went through.”

Craig noticed the benefits of his new aortic valve almost immediately after his TAVR. “The major difference right away was my breathing. I didn’t have to struggle to read, talk or walk. I didn’t realize how much I had been gasping for air before this.”

He credits the Johns Hopkins Medicine Structural Heart Program at Suburban, along with the diligence of his long-time cardiologist, for making his successful outcome possible.

“I’ve been given another lease on life. Most important to me is keeping up with my family, including my five young grandchildren. Now I can stay more active, be healthier and participate to a greater degree in their lives.”