At Swedish, patients now have the ability to undergo transcatheter aortic valve replacement (TAVR) while under conscious sedation, rather than under general anesthesia (otherwise known as “deep sedation”). TAVR is a method used to replace a heart valve without using traditional open-heart surgery and is an option for patients due to age, frailty or other medical conditions.
While under conscious sedation, patients will not feel any pain and may even be awake and able to communicate with their caregivers.
Dr. David Stout, Chief of Cardiovascular Anesthesiology for the Swedish Heart and Vascular Institute led the transition to conscious sedation with the TAVR procedure at Swedish.
“Using conscious sedation eliminates risks associated with general anesthesia as well as the need for a breathing tube, which is challenging for some patients to tolerate,” said Dr. Stout. “Conscious sedation also reduces recovery time considerably, with some patients even sitting up and walking on the same day as their surgery.”
“I was walking around within 12 hours,” said Susan Goodman, who was suffering from aortic stenosis before her TAVR procedure with conscious sedation at Swedish earlier this summer. She was able to leave the hospital 46 hours after her procedure. “There was no pain or anything. I think maybe I took a Tylenol for a headache and that was it. Originally, I thought I was going to have to have open-heart surgery so this procedure completely changed my experience and my life.”
The TAVR procedure differs from traditional valve replacement surgery in the way that the doctor replaces the damaged valve with the new, artificial valve. Rather than opening the chest wall to access the heart and surgically remove and replace the diseased valve, the doctor makes a small incision in an artery in the groin and threads a thin catheter up the artery. The new valve is then moved through the catheter into position across the diseased valve. After ensuring the valve is correctly positioned, the doctor uses a small balloon to open the valve. The new valve, which is about the diameter of a dime when fully opened, immediately takes over responsibility for controlling the blood flow.
“TAVR has become somewhat common for high-risk patients but using conscious sedation for this procedure is still very unique,” said Sameer Gafoor, Medical Director for Structural Heart Disease at Swedish Medical Center. “It has made a dramatic difference for so many of our TAVR patients and is now the default choice for all TAVR procedures at Swedish. Many thanks to Dr. Stout and Dr. Glenn Barnhart for their leadership in making this happen.”
Please visit here for more information on the TAVR procedure.