St. Luke’s study touts alternative to heart valve replacement surgery

After careers in Major League Baseball and construction, Overland Park resident Fred Kipp isn’t used to being laid up and unable to get around.

So when he found out he needed a heart valve replaced because of aortic stenosis, he was not keen on the traditional surgery, which includes cutting through the sternum, cracking open the ribcage and a lengthy recovery period.

“That was an option when they first started talking,” said Kipp, who pitched for the Dodgers and Yankees from 1957-1960 after graduating from Emporia State University. “That was definitely in the picture at that time.”

Through talking to people at his church, he learned about another option at St. Luke’s Hospital: a minimally invasive procedure called transcatheter aortic valve replacement, or TAVR. In the procedure, surgeons make a small incision near the groin to access the femoral artery, then push the new valve through the artery until it replaces the calcified, damaged one.

The procedure has been common since about 2007, but it’s been reserved mainly for patients at a high risk of complications if they have open heart surgery. Not enough was known about how well it worked long-term compared with the traditional procedure.

Traditional surgery set a high standard clinically. Though painful to recover from, it’s usually safe and successful.

But St. Luke’s doctors just published the results of a study that suggests the TAVR procedure is also a good alternative for patients like Kipp, 85, who are classified as “intermediate risk.”

The study, published last month in JAMA Cardiology, found that patients at intermediate surgical risk had comparable long-term results with TAVR versus open heart surgery. As expected, they also had easier recoveries in the first month post-surgery.

Suzanne Baron, a cardiologist at St. Luke’s and one of the study’s authors, said the findings could open up new options for patients with valve conditions, which the American Heart Association estimates kill 25,000 Americans a year.

“It’s neat to have options for patients who, 10 years ago, we really didn’t have anything to offer,” Baron said.

The St. Luke’s study was unblinded, which means patients like Kipp got to choose which procedure they would have. It was funded by Edward Lifesciences, a company that produces transcatheter heart valves. Baron said St. Luke’s uses Edward Lifesciences valves but also uses valves made by a competitor, Medtronic.

Other local hospitals also are using TAVR procedures. North Kansas City Hospital offers it to patients at high or intermediate surgical risk who meet certain conditions. The University of Kansas Health System has two aortic transcatheter valve options approved for high-risk and moderate-risk surgical patients and is conducting a clinical trial for patients at low risk. KU surgeon George Zorn has studied and written about the risks and benefits of TAVR.

Baron said St. Luke’s is beginning a new clinical trial for patients who face low risk from open heart surgery to see how TAVR stacks up for them. Researchers are also studying new materials to use for replacement aortic valves and new procedures for repairing the other three heart valves in addition to the aortic.

“It’s a really exciting time from a structural cardiology standpoint,” Baron said.

Kipp said he was sedated but awake for his TAVR procedure. There was hardly any pain, and he got to go home the next day. The most uncomfortable part, he said, might have been the hard operating table and the cold operating room. But it beats the alternative.

“I was tickled to death that I didn’t have to have open heart surgery,” Kipp said.

This story was originally published July 10, 2017 at 5:32 PM with the headline "St. Luke’s study touts alternative to heart valve replacement surgery."