The UNC TAVR Program successfully performs its first patient procedure

James Aspell of Durham was the first patient to undergo the TAVR procedure at UNC in November 2014

The UNC TAVR Program successfully performs its first patient procedure click to enlarge Thomas Caranasos, MD, Michael Yeung, MD, and John Vavalle, MD, perform the first TAVR procedure at UNC.
The UNC TAVR Program successfully performs its first patient procedure click to enlarge James Aspell of Durham is the first patient at UNC to undergo the TAVR procedure to replace his aortic heart valve

James Aspell is used to being treated at a great hospital.  When he and his wife lived in Boston, they were treated for various illnesses at Beth Israel Deaconess Medical Center, which is one of the teaching hospitals for Harvard Medical School.

Since relocating to Durham in 2013, there has been only one place the Aspells would go for their medical care:  UNC Hospitals and the UNC Center for Heart & Vascular Care.

In November 2014, Aspell became the first patient at UNC to receive a new heart valve using transcatheter aortic valve replacement, or TAVR. TAVR heart

TAVR is a new technology that provides a treatment option for aortic valve replacement for many patients who previously had no other options or were at high risk for conventional open heart surgery. With TAVR, physicians now have the ability to provide aortic valve replacement via minimally-invasive approaches, including percutaneous procedures (intervention without an incision), which provide outcomes that are as good, or sometimes better than, surgical valve replacement.

Aspell suffered from aortic valve stenosis, which occurs when the opening of the aortic valve becomes calcified and thick, and the valve no longer opens fully with each heartbeat.  The aortic valve is located between the left ventricle of the heart and the aorta, the largest artery in the body.  Aortic stenosis becomes increasingly common with age, predominantly affecting those over the age of 65. When symptoms, such as shortness of breath, develop from aortic stenosis, the average life expectancy is only 1-2 years, with a prognosis that is worse than most cancers if left untreated.

During a Transcatheter Aortic Valve Replacement (TAVR) procedure, the patient's aortic valve is replaced using a minimally-invasive approach which doesn't require open heart surgery.

Unfortunately, at least 1/3 of patients with aortic valve stenosis today are not receiving valve replacement, which is the only treatment that is effective for this condition.  This is because many patients who have severe aortic valve stenosis might be too frail or too ill for conventional open heart surgery.  Image by Edwards Lifesciences (tm) LLC, Irvine, CA

“I had such awful shortness of breath that I couldn’t walk across a room without stopping to rest,” explains Aspell.  “My primary cardiologist, Dr. (Charles) Hicks, suggested that I discuss the TAVR procedure with the new team of doctors at UNC.”

Aspell met with John P. Vavalle, MD, Assistant Professor of Medicine in the Division of Cardiology, and Thomas Caranasos, MD, Assistant Professor of UNC Cardiothoracic Surgery.  Both serve as co-medical directors of the new TAVR Program at UNC, along with Michael Yeung, MD.

“I knew as soon as I talked with them that I wanted them to do the procedure,” says Aspell. “They encouraged me to get a second opinion, but after seeing their enthusiasm and great bedside manner, I knew UNC was the right place for me.”

Dr. Vavalle says, “The TAVR procedure, by definition, is multidisciplinary. Patients win when they can be evaluated by a multidisciplinary team, who then together can decide on the best treatment option and provide the highest level of care.  By pooling all of our knowledge, expertise, and resources together, all options are evaluated, and we can provide the best patient care.” 

Dr. Caranasos adds, “We are going to be at the forefront of not just using the technology but developing and advancing the technology.  We are one of the world’s leading academic medical centers. The TAVR program is centered around the absolute best patient care, supported by two pillars of strength underneath: education for our trainees and research to move this field forward.”

As Aspell recuperated at UNC, he was amazed at how he felt. “I have no pain, not even a touch of pain from the procedure.  I’ve walked around the recovery floor already and only had to stop a few times.”

He adds, “The administration at UNC does a heck of a job hiring the right people!  I’ve gotten exceptional personalized attention and every single person has been pleasant.”

As for Aspell’s future plans, he hopes to make it back to the UNC basketball games this season with his daughter and son-in-law.  “Climbing those steps in the Dean Dome were quite a challenge last year, but I can’t wait to see how well I do now!”

The TAVR Program at UNC is actively seeking new patients and physician referrals.  Cassie Ramm, RN, BSN, serves as the TAVR Program Coordinator.

For more information on the TAVR Program, contact Cassie Ramm, Dr. Vavalle,  Dr. Caranasos, and Dr. Yeung.

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