4 LOVE YOUR HEART
The Messenger-Inquirer Tuesday, Feb. 1, 2022
TAVR PROCEDURE
OH doctor performing procedure that once required open-heart surgery
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BY CHRISTIE NETHERTON MESSENGER-INQUIRER
s part of its efforts to place an emphasis on cardiology and heart-related procedures and treatment, Owensboro Health Regional Hospital recently began its structural heart program. Through the program, under the direction of Dr. Ashish Rastogi, the hospital has performed 15 transcatheter aortic valve replacement (TAVR) procedures to treat patients suffering from aortic stenosis. Several more are scheduled for the coming months. Rastogi, an inter ventional cardiologist with specialized training in performing TAVRs and other heart procedures, said bringing the procedure to Owensboro allows patients in need to receive the ser vices close to home rather than traveling to another state or city. “I was looking for a place to do these procedures in a community that would benefit from it and Owensboro seemed to be the perfect situation because they wanted to start a program,” he said. “They have a hospital that has high-end facilities and can really provide these ser vices to the community; they just needed a physician to do it.” Rastogi began performing TAVRs in August this year, having performed nine so far with 15 patients scheduled throughout the next month or two. Since the program started up, he said he has received about two or three referrals per week. TAVR, he said, is a minimally invasive procedure used to treat aortic stenosis, which is blockage of the main valve. A TAVR replaces a narrowed aortic valve that fails to open properly — an aortic valve stenosis. In this procedure, doctors insert a catheter into the leg or chest and guide it to the heart through the old heart valve, using the natural heart
valve to hold it in place. According to Rastogi, the procedure began to become more widely used about five years ago. Prior to that, he said aortic stenosis was treated with open-heart surger y, which is much more invasive and requires a longer recover y time. Additionally, he said, open-heart surger y is not as ideal for patients who might have underlying medical conditions that might make them more at-risk for an invasive procedure with a difficult recover y process. Such underlying conditions might include lung disease, COPD, individuals who have has strokes in the past, are debilitated or have multiple underlying medical conditions. “Before 10 years ago, the only way to treat aortic stenosis was with surger y,” he said. “Now, the standard of care is to have TAVR for aortic stenosis for the majority of patients instead of having surger y.” TAVRs, he said, are not only more minimally invasive than open-heart
get seen by a doctor and get it figured out,” he said. “We know that when someone has severe aortic stenosis blockage to that degree and have symptoms of it, they don’t do ver y well long-term.” About one-in-five individuals with the disease who do not receive treatment, he said, do not live past five years and 50% might pass away after two years of experiencing symptoms. “Recognizing it and treating it is really important,” he said. Bringing the procedure, along with other heart-focused treatments, to Owensboro, Rastogi said, creates better access for individuals to seek out care and consultation locally if they are experiencing symptoms or have concerns, rather than living with a disease that is treatable. surger y, but have a shorter recover y “Bringing this to the community time. Whereas open-heart surger y here, I think, is really important might require a week or longer of because it’s a procedure … and not recover y in the hospital, the TAVR having to leave their community procedure is typically about an in Owensboro and having to go to hour-long procedure with a day-long Nashville or Louisville or somewhere recover y process before the patient a few hours away,” he said. being can be discharged. able to get this … procedure more Rastogi said aortic stenosis is locally and have follow up here is actually quite common with about much better for them.” one-in-eight individuals ages 75 and TAVR is the latest in a series older experiencing some level of the of innovations within OH’s heart disease. program during the past year. Dr. “It’s ver y common,” he said. Rastogi has also began implanting “When it is severe, it can limit blood the MitraClip device, which is flow to the whole body.” an alternative to open heart However, he said, many of these surger y for patients with a leaky individuals who feel symptoms mitral valve, and the Watchman of the disease might not even get device, which is an alternative to it checked out as the symptoms blood thinners for patients with commonly get confused with regular atrial fibrillation. OHRH has also signs of aging. expanded its cardiac imaging and Symptoms of aortic stenosis might electrophysiology capabilities, include fatigue, lightheadedness, renovated the catheterization lab dizziness, chest pain and fainting and partnered with Cincinnati spells. Children’s to provide pediatric “They don’t recognize that they cardiology ser vices. actually have a valve issue, so a lot Christie Netherton, cnetherton@ of it goes unrecognized and the majority of patients actually never messenger-inquirer.com, 270-691-7360
