Health First Celebrates 500th Specialty Heart 
Valve Replacement Procedure

By  //  March 11, 2021

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Brevard’s only one-stop heart shop provides new life to patients in two days

HOLMES REGIONAL MEDICAL CENTER’s Valve Clinic recently performed the 500th transcatheter aortic valve replacement, or TAVR, a procedure that places a fully collapsible replacement valve into a diseased one by way of a catheter. When the new valve expands, it pushes the old valve leaflets out of the way and takes over the job of regulating blood flow. (Health First image)

BREVARD COUNTY, FLORIDA – Transcatheter aortic valve replacement may sound like something new to the Space Coast, but the revolutionary heart treatment has been helping Brevard patients for some time.

Commonly known by its acronym, TAVR, this procedure has been offered by Health First for more than five years now.

Brevard’s community healthcare system has performed more than 500 TAVRs with its unique, one-stop-shop process at the Health First Valve Clinic, located within the Heart Center at Health First’s Holmes Regional Medical Center.

Having this local, high-quality option helps provide more comfort and less travel time for local residents.

From meeting with the interventional cardiologist and cardiac surgeon to any necessary pre-procedure tests, the Valve Clinic provides the convenience of connected cardiac care at one location.

“We have the most experience performing both TAVR and MitraClip procedures between Fort Pierce and Jacksonville since we offer the Valve Clinic, providing many of the options you can get if you traveled to Orlando heart treatment centers,” said Dr. Matthew Campbell, a Health First Cardiothoracic Surgeon.

“Since 2017, we are the only fully integrated structural heart program in Brevard.”

Health First cardiac doctors Dr. Matthew Campbell, left, and Dr. Dinesh Patel.

During a TAVR procedure, a new heart valve is inserted into the existing, diseased one. It’s like placing a stent in an artery, delivering a fully collapsible replacement valve through a catheter.

When the new valve expands, it pushes the old valve leaflets out of the way – and the material in the replacement valve takes over the job of regulating blood flow.

Patients with the following valve diseases who can benefit from TAVR or MitraClip procedures include:

■ Aortic stenosis, which occurs when the aortic valve is narrowed and doesn’t open completely
■ Replacement of a worn-out surgical valve, which was placed by a previous open-heart surgery
■ Mitral regurgitation, which occurs when the mitral valve does not close properly and allows blood to flow backward in the heart.

“The TAVR surgery at Health First has evolved through multiple stages, beginning in June 2015, so for a little more than five years, we have streamlined the process,” said Dr. Dinesh Patel, who oversees the Valve Clinic with Dr. Campbell.

“As with any new technology or procedure, we learn new things, and it has added a lot of experience. We streamlined the process to make it easier to discharge patients faster, and the biggest evolution is the newer generation devices we now use, so the complication rate goes down.”

For patients who have adequate blood vessel size, doctors perform the TAVR procedure from within the blood vessel itself, sidestepping any large incisions. They also utilize numerous techniques for alternative access for more complicated cases.

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Over time they have changed some of the details about how they deploy the valves, which has dramatically reduced the most common complication – a patient needing a pacemaker.

All patients are cared for by cardiac anesthesiologists, who also take part in all heart surgery cases. The average hospital stay is just under two days, thanks to a special unit of nurses and staff who provide care for these patients on one floor.

This kind of focus becomes very important when treating sicker, more fragile, patients who have very low heart function and multiple conditions.

“We recently had one patient who just dramatically improved – somebody who could barely walk to the door is now doing laps around the hallway,” said Dr. Campbell.

“That kind of success requires some experience and a team approach between cardiology, heart surgery, anesthesia, even perfusion for that case where we had to use the heart-lung machine to help place the TAVR valve– whatever it takes to get them safely through the procedure. We tailor the procedure to the patient because we have all the tools in our toolbox and provide a full-service Valve Clinic, where every patient with severe aortic stenosis can be treated.”

The TAVR team makes an evaluation together, then decides if the patient is best served with TAVR or a minimally invasive open-heart surgery.

Heart surgery is typically utilized for patients who are younger and healthier, while TAVR is traditionally geared toward older, less healthy group of patients, including those 70 years old and above.

While heart disease can be caused by a number of factors – such as high cholesterol, age, genetics or calcium buildup – they’re important to address as early as possible to help decrease your risk of heart failure.

Find out if you are at risk for heart disease by taking the free assessment at www.hf.org/hearthealth

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