Health & Wellness

Colorado Health & Wellness | Spring 2016

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Health and Wellness Magazine • 27 Once it reaches the severe state, what is the survival rate? Dr. Sperling: It's said that patients who have severe symptomatic aortic stenosis have a two-year survival rate of about 50 percent without surgery, which is really dramatic. Very few conditions have only a 50-percent two-year survival, not even some advanced cancers. And with surgery? Dr. Sperling: That can depend on a lot of things. It depends on how old you are; it depends on what other medical problems you have. But, it's typically much, much better than just observation. How often do you see patients with this problem? Dr. Sherman: It's one of the more-common diagnoses that we see. And, as our pop- ulation is getting older, and people are living longer, we are seeing more cases and more severe cases. In my practice, we're seeing at least several patients a week. When you see people in this severe state, what are their lives like? Dr. Sperling: They can become easily winded and unable to do every-day activities. Sometimes dizziness, fainting, leg swelling and chest pain can occur, generally in later stages. Low energy can have a huge effect on quality of life, and there is a risk of sudden death. Why might TAVR be a better option for some patients? Dr. Sherman: For some high-risk patients, TAVR is the only option. It's about offering a good therapy to patients who might not have had any therapy offered to them at all. Right now, Medicare has restricted TAVR to high-risk patients o r p a t i e n t s w h o a r e " i n o p e r a b l e , " who cannot have the traditional valve surgery for some reason. Our hope is that, with newer data coming out on TAVR-patient outcomes even this year, Medicare might begin covering the procedure for intermediate-risk patients. With TAVR, we don't have to open the chest, patients don't have to go on a heart-and-lung machine, and hospital stays and recovery times can be much shorter. Do TAVR patients have the option of either a mechanical or a biological valve? Dr. Sperling: TAVRs are only biological; they are all tissue valves, which is actually better for patients, because they don't have to be on major blood thinners or other medications to reduce the risk of clotting. Why is your team approach important? Dr. Sperling: It's all about the complement- ary skill-sets: We each bring different e x p e r t i s e t o t h e t a b l e . I t h i n k t h e patients benefit dramatically from this multidisciplinary team approach, and I think it's the future in cardiovascular care. How has TAVR helped your patients? Dr. Sherman: For some patients, we can help them live longer and do the things they want to do again. A patient we saw yesterday, he is 30 days out from having his TAVR done, and he was just ecstatic. He would not have been doing so well 30 days after open-heart surgery, and we are so happy we had this less-invasive therapy to offer him. He's back to exercising, doing things with his family, and looking forward to traveling. As he put it, he has a whole new lease on life. Appointments: 303-597-4239 Visit: The Edwards SAPIEN 3 transcatheter heart valve is constructed of bovine pericardial leaflets, from the durable sac of tissue surrounding a cow's heart, hand sewn onto a metal frame that is crimped onto a balloon-expandable catheter. The heart valve has an outer sealing skirt designed to prevent paravalvular leak. The Edwards SAPIEN 3 transcatheter heart valve is crimped onto a delivery catheter and threaded up into the heart through an artery in the leg. Once inside the body, a balloon inflates and the valve expands into place. Dr. Jason Sperling (left) and Dr. Jonathan Sherman

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