FEATURE | Posted April 24, 2017

Back on the bike trail

TAVR restores a retiree's active life

Terry Caldwell stays busy with cycling, walking, tai chi, kayaking, dancing, and visiting with his children, grandchildren and great grandchildren. The former carpenter has had a few health issues since retiring, but nothing that set him back for long. Even, at least at first, a heart condition known as aortic valve stenosis.

Cardiologists Garrett Wong (left) and Jeffrey Southard are part of UC Davis team dedicated to using minimally invasive treatments for heart valve disease.
Cardiologists Garrett Wong (left) and Jeffrey Southard are part of UC Davis team dedicated to using minimally invasive treatments for heart valve disease.

“For a long time, it really didn’t bother me,” Caldwell said, recalling that he and his primary care physician decided on a cautious oversight approach when he was first diagnosed. “It wasn’t advanced enough to worry about.”

Symptoms, however, are inevitable. The disease progressively restricts blood flow from the heart through the aortic valve and to the rest of the body as calcification increases, narrowing the valve opening and thickening leaflets that regulate blood flow.

One day, Caldwell started having trouble breathing.

“It was like panic attacks,” he said. “It was almost intolerable. I couldn’t walk half a block without stopping.”

Assuming he had lung problems, Caldwell made an appointment with a UC Davis pulmonary specialist. When the exam instead indicated signs of heart failure, he was sent right away to the emergency department and admitted to UC Davis Medical Center, where he met interventional cardiologists Garrett Wong and Jeffrey Southard.

The Sacramento region’s first and one of the nation’s most experienced TAVR programs is at UC Davis, where next-generation prosthetic valves are currently being tested. For more information or to request a referral, call 916-734-6500.

Wong and Southard have specialized training in using minimally invasive, catheter-based treatments to treat structural heart problems. They use transcatheter aortic valve replacement, or TAVR, for patients like Caldwell with severe symptomatic aortic valve stenosis.

Open-heart surgery used to be the only option for treating the condition. Those unable to have surgery received symptom management or, in some cases, referrals for hospice services. TAVR changed all that.

“This is a groundbreaking and revolutionary procedure that allows more than just surgical patients to benefit from valve replacement,” said Wong. “Our patients are thankful there is an option available that can improve the quality of their lives.”

Cardiovascular medicine at UC Davis Health unites specialists and subspecialists who are passionate about providing the highest level of care for cardiac and blood-vessel disease. In addition to being compassionate clinicians, they are national leaders in developing and testing new cardiac and vascular therapies, technologies and surgical techniques, and then making them available to patients worldwide. For information, visit heart.ucdavis.edu.

The procedure involves placing a catheter into a large artery and threading it through vessels to the damaged valve, creating a delivery path for a replacement. The new valve is placed within the calcified leaflets, where it is held securely in place, opening and closing like healthy leaflets and restoring normal blood flow. (View a detailed video about the TAVR process on the UC Davis Health YouTube channel.)

TAVR is currently approved for patients at high- or intermediate-risk for open-heart surgery, and Caldwell was an optimal candidate. After being admitted to the hospital on a Friday, he had TAVR the next Monday and was discharged on Wednesday. He continues to have follow-up evaluations with Wong a couple times a year.

Today, three months later, he is back to cycling and his normal routine.

“I feel a helluva lot better,” Caldwell said. “I’m taking it easy but getting back in shape. And I am very grateful for what Dr. Wong has done.”

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