For James Carleton, tennis is a second career. He took up the sport in his late 50s and became a regular on the senior circuit. But when he collapsed on a court last year at age 91, he feared that second career might be over.
The general contractor from Redding was told he had aortic valve stenosis, a disease that reduces blood flow from the heart through the aortic valve to the rest of the body due to calcification, a prior infection or a birth defect.
People with aortic valve stenosis may not experience typical symptoms -- such as chest pain, dizziness and fainting -- until late in the course of the disease. Often, but not always, it is an age-related condition: It is estimated to affect 2 to 4 percent of people over age of 65.
The traditional treatment is open-chest surgery to replace the damaged valve -- an option that Carleton's cardiologist did not recommend. He was instead referred to UC Davis, the only hospital in Sacramento currently offering a minimally invasive treatment recently approved by the U.S. Food and Drug Administration called transcatheter aortic valve replacement, or TAVR.
"For some, the disease is too advanced or they have other health issues that prevent them from being good candidates for surgery. For those patients, the disease is often fatal within a year," said Jeffrey Southard, an assistant professor of cardiovascular medicine who, together with Cardiovascular Medicine Chief Reginald Low, leads the new TAVR program at UC Davis. "It is remarkable to have another lifesaving option that also restores quality of life more quickly than open-heart surgery."
Carleton was evaluated at UC Davis and approved for the procedure, which took place Feb. 27. Working with a team of interventional cardiologists and cardiothoracic surgeons, Southard moved a tightly compressed new valve through a catheter inserted in Carleton's femoral artery until it was positioned inside the diseased heart valve. A balloon was inflated to deploy the replacement valve. When the balloon was deflated, the new valve remained open, restoring normal blood flow.
"Ever since I became ill, I hoped to play tennis again with my family and in national level tournaments," Carleton said. "Dr. Southard says I can start practicing in 10 days, which is simply amazing."
Carleton was Southard's second TAVR patient. His first, 90-year-old James Cook of Yuba City, had the procedure earlier on the same day. They were both discharged from the hospital March 1.
The UC Davis Cardiology Valve Clinic has a growing list of patients in inland Northern and Central California who have been waiting for a nonsurgical treatment option for aortic valve stenosis.
"TAVR is one of many less-invasive procedures that are revolutionizing cardiac care and altering the course of cardiovascular diseases," said Low. "UC Davis is committed to making sure that these opportunities are available as quickly as possible for patients in our region."
To be considered for TAVR, patients must first be excluded as candidates for open-heart surgery. For more information or to request a referral to the Cardiology Valve Clinic, call 916-734-6500.
Cardiovascular medicine at UC Davis unites specialists and subspecialists who are passionate about providing the highest level of cardiac and blood-vessel care. In addition to being compassionate clinicians, they are national leaders in developing and testing the next generation of cardiac and vascular therapies, technologies and surgical techniques, and then making them available to patients worldwide. For information, visit www.ucdmc.ucdavis.edu/heart/