California veteran turns 100 with a little help from his high-tech heart

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An operator established in the Navy for more than two decades, Velvin Bill of La Mesa often throws metal parts for shipwrecks, allowing ships to continue to travel for many years after construction. they.

Appropriately, therefore, this veteran of World War II came to celebrate his 100th birthday last week with a little help for his pump. Two years ago, he had a major heart attack when his original equipment began to fail.

Like many over 90, the aortic valve He was born with severe dehydration, causing severe injury as blood with low oxygen flows out of his main chamber to the rest of his body. Like a shipwreck, it slows him down, slows him down in his house, and deprives him of the opportunity to exercise.

It has been possible to replace the old heart valve since the 1960s. But until recently, the option was not available to those over 90 because sewing in a new model made from pork or beef required heart surgery. Many in their ten years of life are considered incapable of surviving and opening their chest cavity.

But compared to the so-called new technology transcatheter aortic valve replacement or TAVR drowns out these old assumptions. The smartly built spaces built into the destructive wire support structures allow the team of cardiologists to deliver the correction through the movement of the nerves of the body, allowing the recipients to bypass the pulse of the heartbeat surgery.

Open heart rate as a whole means one week in a hospital bed and one month at home. But TAVR generally requires only one day before returning home and continuing to live.

For Bill, the difference was immediate. Like most, the upgrade is near.

“It’s amazing, because I’ve never felt so tired,” Bill said.

“When he comes home from the hospital, I can immediately notice, how he walks around the house and can do a lot of things without getting too tired,” said Debbie Bill, Velvin’s daughter who lives far away from his house.

It is an experience that has become commonplace as TAVR has gradually replaced the opening of the open heart valve since the technology first gained federal approval. critically ill patients in 2012.

Dr. Jeffrey Cavendish, a radiologist involved with Kaiser Permanente and head of the cardiology department at Memorial Scripps La Jolla Hospital, explains that it is not just the TAVR model that has contributed to recent success.

Today’s imagery can show blood flow and heart system in detail, allowing teams to determine if the device is working properly. The catheters used to deliver the travel valve in the femoral vein are accessed with a small incision in the groin or, more recently, through a small vein in the arm. A photo can help to look at the path and identify potential problems before deciding to move forward.

“The kind of photography we have today allows us to have our road map, our game plan, all set before we start, so when the time comes for planning, we just have to implement it,” Cavendish said.

Kaiser San Diego has now produced more than 600 TAVR valves since 2012, with over 270,000 TAVR valves installed nationwide by 2019, according to a special annual report published in 2021 by the Society of Thoracic Surgeons and the American College of Cardiology. By federal law, the results of any TAVR procedure performed in the United States must be recorded in a special registry in order to identify problems.

Recent reports suggest that TAVR dominated surgical valve replacement in 2015 or 2016, becoming more common than surgical replacement with other cardiac procedures such as heart circumference in late 2018 and early 2019.

Dr. Vinod Thourani, chief operating officer of cardiovascular surgery at the Marcus Heart Valve Center in Atlanta and chairman of the registration committee for valve replacement, says the use of national TAVR approaches 85,000 cases every two years past.

Practicing the TAVR project half a dozen times a day, Thourani has seen the technology and expertise evolved since he installed his first valve under the first test rules in 2006. As his use exploded in recent years, the doctor said some estimate that only about 20% of those who could benefit are receiving the TAVR valve today.

The main symptoms of stroke are chest pain or compression, dizziness or shortness of breath, which are more common during exercise. Older patients, especially those in their 90s, are still being offered treatment instead of TAVR.

“There are many patients with severe aortic valve stenosis who do not have the option of surgery or this treatment,” Thourani said. “We think it’s a tragedy, because you can really turn someone’s life around in one day.”

Analysis of registry data showed that it gradually became safer for patients.

According to a new study, total hospital mortality after TAVR fell from an initial 5.4% to 1.3% in 2019.

The mortality rate for patients considered to be at high risk fell from 24% to just less than 17% one year after surgery. The number of strokes after surgery also decreases as the number of patients who end up need a heart rate monitor after TAVR.

As intermediate heart disease groups gain more experience, they are becoming more and more willing to trust patients like Bill who are past their 90th birthday.

Thourani said he recently put one of the valves in a 103-year-old woman.

“She went home the next day in her Mustang with her family,” he said. “He went well.”

At home, Cavendish says Bill is the oldest TAVR patient of Kaiser San Diego, and many who have received the device in recent years turn 100 by 2022.

Some may not be qualified because of the limited range of motion in their body, or because they suffer from certain serious illnesses that will prevent them from having a good prognosis for a long time, even with a new, more active heart valve.

“We want to make sure that this will benefit patients, that they will feel better and live longer,” Cavendish said. “We’re not going to do anything like that because we can only do it.”

While there are many people who have a low pressure valve type which makes them a good candidate for TAVR, the device will not be able to fix some issues, such as valve regurgitation, condition and some blood that was previously shed returned to the heart.

Because regurgitating valves have systemic damage, rather than being sustained by calcium deposits, TAVR often does not work because the device may not be as effective in the surrounding tissue.

“We don’t want to make it valve in it and cause it to slip or move, “Cavendish said.” If we are worried that we will not get a good seal, then we will send the patient to open-heart surgery instead. “

Of course, patients who have successfully performed TAVR often have some health problems that do not go away after surgery. This is the case with Bill, who suffers from degenerative disease that prevents him from seeing the details. The illness forced him to give up some of his favorite hobbies, including flying his private jet and working on a tall timber.

Born in 1922 on a farm in Oklahoma and one of 14 children, he came to California with his parents just as the Great Depression began, enlisted in the Navy when he turned 19, and decided to stay in San Diego with his wife, Marian. after two years repairing Navy ships in the South Pacific during the war.

Although his options are narrower than they are, and probably better than his preferences, Bill says he has no problem finding reasons to get up in the morning. The perfect blood circulation, while not tackling all the problems of years, helped him get outside often, especially with Debbie at his side while walking regularly at nearby Lake Murray.

Although he prefers to see his eyes return to the eloquence he once enjoyed, he can still listen, whether of books on tapes, soccer or family, including six grandchildren, one grandchild and two great grandchildren .

“Just find something you want to do, even if you don’t see it or you can’t do it as you usually do,” he said.

Occurrences in aortic valve replacement between patients and dementia

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