Until just a few years ago, the only treatment option for many people diagnosed with a life-threatening heart valve condition was open heart surgery, a procedure too risky for many of the patients who needed it. However, with the introduction of transcatheter aortic valve replacements (TAVRs), these high-risk patients can be treated with a minimal incision and hospital stay – and this revolutionary surgery is now being offered in Kaiser Permanente of the Mid-Atlantic States (KPMAS) as part of our strategic goals to invest in capabilities to ensure growth and performance and deliver affordability.
Mid-Atlantic Permanente Medical Group cardiologists, Dr. John Golden and Dr. Ameya Kulkarni, along with our Virginia Hospital Center (VHC) partners, have recently completed the very first TAVRs at VHC. In fact, two of the surgeries happened just hours before Winter Storm Jonas struck, and all of the procedures were very successful, allowing the physicians to replace the aortic valve in these high-risk patients without cutting open the chest and while the patients were awake.
Dr. Golden and Dr. Kulkarni wanted to bring TAVR to KPMAS and began spearheading the program about 18 months ago. “Over the last many months, each of you has contributed meaningfully to the conception, evaluation and execution of this amazing procedure,” said Dr. Kulkarni in a message to his team. “Its success could not have been possible without your work and support.”
The TAVR procedure is a minimally invasive surgical procedure that repairs the valve without removing the old, damaged valve. Instead, it wedges a replacement valve into the aortic valve’s place. TAVR is a fairly new FDA-approved procedure for people with symptomatic aortic stenosis and who are considered high-risk for standard valve replacement surgery. Coordination of care is key for these highly technical procedures, so we were able to leverage our integrated care delivery model to expedite pre-operative consultations, appointments, and tests.
Currently, the only TAVR surgeries in our region are being conducted at VHC. However, since the TAVR program is so streamlined, a member living in Baltimore, for example, would only need to go to VHC twice (once for meeting with the surgeons before the procedure, and a second time for the surgery itself), with all pre-operative appointments done either virtually or at their home center in Baltimore. “We wanted to make sure that our patients get the same attention to detail care and state-of-the-art technology wherever they are,” said Dr. Kulkarni.
Additionally, Dr. Kulkarni wanted to share the patients’ stories and how their lives were changed with this revolutionary procedure:
One of the patients is a doctor of theology and spent most of his life doing mission work all over the world. His bride of more than 60 years is severely demented and only anchors to his presence. His hope was to be able to help in her care, so in these dark days for her, he could remain her light. His aortic stenosis, however, prevented him from giving her any meaningful support. It also prevented him from putting his shoes on, walking more than a few feet and really functioning at all. Four days after the TAVR, he went back to his wife with more energy than he has had in a long time and with a new sense of purpose.
One of our other patients is a politics buff. It is her passion and if she could, she would spend her time reading every scrap of political news. However, her aortic stenosis caused such profound dizziness that she was very limited in her activity and her ability to read the newspaper. She went home after spending the weekend racing the nurses up and down the hallways of the ward. I am certain I will have to bone up on the presidential candidates to keep up with her mind when I see her this week!
“We are very grateful for all the work you all do every day to make the lives of our members better,” said Dr. Kulkarni to his team. “I am particularly thankful for all of your support on this project. I hope we will get to work together on many future endeavors. Until then, please accept the gratitude of our clinical TAVR team and the families of our patients.”
Let’s celebrate this success with Dr. Golden, Dr. Kulkarni, and their teams at VHC and congratulate them on bringing this life-changing procedure to KPMAS to help us continue to provide exceptional care to our patients and members.