TAVR Technology Saves Elderly Couple with Aortic Stenosis

NEW HYDE PARK, NY -- Marie and Joseph Nigro of New Hyde Park believe in sharing everything.

They eat the same foods, enjoy the same type of music and, after 66 years of marriage, discovered they were both suffering from aortic stenosis.

“It got so bad that my husband couldn’t even tie his shoes,’’ Mrs. Nigro said of her 92-year-old husband this week when she returned to Long Island Jewish Medical Center in New Hyde Park with her mate and their family to meet the press. The couple was joined by their doctors, Jacob Scheinerman, MD, and Barry Kaplan, MD.

Aortic stenosis is so debilitating that it often affects normal day-to-day activities such as walking short distances or climbing stairs. Generally afflicting people older than 70, the disorder occurs when the aortic valve doesn’t open and close properly (usually due to a calcium build-up). The calcium blockage restricts blood flow from the heart to the rest of the body, thereby increasing pressure within the heart, increasing the risk of heart failure. Symptoms include extreme fatigue, chest pain or pressure, shortness of breath and fainting. All of these symptoms were becoming very familiar to the Nigros.

Dr. Scheinerman, vice chair of cardiovascular and thoracic surgery at LIJ, treated both Mr. and Mrs. Nigro, using Transcatheter Aortic Valve Replacement (TAVR). Technology he calls the gold standard of cardiac procedures. Similar in technique to implanting cardiac stents into clogged arteries, doctors use a catheter tube to guide the replacement heart valve through the bloodstream, starting at the femoral artery in the thigh. The cardiac team uses transesophageal echo and fluoroscope imaging guidance for proper placement. Once it reaches the heart, the FDA-approved Sapien valve is expanded to about the diameter of a quarter, pushing away the calcium to enlarge the opening of the valve. It is then anchored inside the aorta and blood flow is restored.

“Ten or even five years ago, this procedure would have seemed unimaginable,” said Dr. Scheinerman. “To be able to offer this to our patients who for whatever reason would be unable to withstand a traditional heart surgery…to see patients like the Nigros undergo an hour-long procedure and then return home in less than a week…it’s still amazing to me. This is why we become surgeons.”

Mr. Nigro’s procedure, which lasted an hour and 20 minutes, took place on June 19. He went home a week later and reported that when it was all over, he “didn’t even know it had started yet. I felt absolutely nothing.”

After witnessing her husband’s improvement and realizing that she, too, was at risk, Mrs. Nigro, 90, had her procedure done on July 31 and returned home four days later. She says that is has lots more energy and is very happy that she and her husband had the TAVR procedure because “we don’t feel old anymore.”


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