TUPELO, Mississippi—Melvin Starnes of Sturgis recently became the 500^th patient to have transcatheter aortic valve replacement (TAVR) at North Mississippi Medical Center.

Open heart surgery is usually done to repair or replace severely damaged heart valves, but unfortunately, not everyone is a surgical candidate. In February 2012, NMMC became the first hospital in Mississippi and the seventh nationwide to offer TAVR, a promising alternative for high-risk patients for whom heart surgery was not an option.

TAVR has been a huge breakthrough for high-risk patients who suffer from aortic stenosis, a narrowing of the aortic valve opening that limits blood flow from the heart out to the rest of the body. Aortic stenosis has been compared to a kink in a water hose that has to be relieved in order to keep the water—or in this case, blood—flowing. Left untreated, a person’s heart could get larger until it has trouble pumping. Fluid could build up in the lungs, and the heart could begin to fail. The heartbeat could become erratic, and the person could suffer a heart attack and die.

Starnes agreed to have TAVR once aortic stenosis began to affect his quality of life. “As I got older, it got worse,” he said. “I’d get out of breath, and sometimes I’d get dizzy and have to sit down.”

TAVR allows a team of doctors to replace a diseased valve without open-heart surgery and without stopping the heart. TAVR is done by a cardiologist and cardiothoracic surgeon together in NMMC’s hybrid operating room, which is a cross between a cardiac catheterization laboratory and a surgery suite.

TAVR can be performed three ways: through an incision in the patient’s leg, carotid artery or between ribs. Next, a balloon catheter is placed across the narrowed aortic valve and stretched open so the cardiothoracic surgeon can place the new heart valve. When the balloon is inflated, it pushes the new valve into position and the diseased valve to the side. The balloon catheter is then removed, and the new valve starts working immediately.

Starnes had the procedure May 3 and went home the next morning feeling fine. He plans to follow his surgeon’s instructions to take it easy for a few days, then he’s looking forward to increased stamina. “I haul off scrap metal and I’ve got some bush hogging to do,” Starnes said.

NMMC cardiothoracic surgeon David Talton, M.D., who performed the first case in 2012 as well as the 500^th case, says TAVR technology has made great strides over the last decade. “The procedure is easier and safer now than it was 10 years ago,” Dr. Talton said. “Patients used to stay three days; now they go home the next day.”

“Open heart surgery is still the treatment of choice for valve replacement,” he added, “but for high-risk patients—those who are older or have other serious health issues—TAVR is an excellent option.”

For more information about TAVR and other procedures offered at NMMC, call 1-800-THE DESK (1-800-843-3375) or visit www.nmhs.net/heart-vascular.