About a year ago, cardiologists told Dennis Eggers the only option to repair his leaky tricuspid heart valve was open-heart surgery. Unfortunately, that surgery comes with serious risks that Eggers, who also had an unrelated lung tumor removed in May 2019, wasn’t comfortable taking.
But on Dec. 11, 2019, Eggers became the first patient in a new clinical trial to receive a minimally invasive device that repaired his faulty heart valve – and without open-heart surgery. The compact device is inserted through a leg vein and is perfectly placed inside a failing valve by a physician using a catheter that’s controlled from outside the patient’s body. The relatively simple procedure enabled Eggers to leave the hospital the following day. Open-heart surgery patients are typically hospitalized for at least a week.
“I was tired all the time,” Eggers recalled how he felt before the procedure. “I basically couldn’t do anything. I was just completely worn out. But, after my valve was repaired, it was a night-and-day difference. As soon as they put the thing in, I felt better. It was instantaneous.”
Easier heart valve repair
The human heart has four chambers, each of which have a valve that controls the flow of blood as it obtains oxygen from the lungs. That refreshed and recirculated blood supplies the body with oxygen we need to live.
It’s becoming more common to repair faulty heart valves through catheters because it enables patients to recover much more quickly. But the tricuspid valve – which sits between the top and bottom chambers on the right side of the heart – has very complex features and was only repairable through open-heart surgery, until recently.
“Open-heart surgery can be grueling and even dangerous for patients with more than one severe health condition,” said one of the physicians who led Eggers’ procedure, Firas Zahr, M.D., an associate professor of medicine (cardiovascular medicine) in the OHSU School of Medicine and co-director the OHSU Knight Cardiovascular Institute’s Complex Heart Valve Program.
“Many older or frail patients are not good candidates for open-heart surgery,” Zahr continued. “But many of those same patients can go home the day after having a transcatheter heart valve procedure.”
Zahr performed Eggers’ surgery with Howard Song, M.D., Ph.D., a professor of surgery (cardiothoracic surgery) in the OHSU School of Medicine and the other co-director of the OHSU Complex Heart Valve Program, along with Scott Chadderdon, M.D., an assistant professor of medicine (cardiovascular medicine) in the OHSU School of Medicine who led the use of echocardiography essential for transcatheter heart valve procedure.
OHSU is the only hospital in Oregon that repairs and replaces all four heart valves with a catheter, through both FDA-approved procedures and OHSU’s involvement in clinical trials.
‘I can do so much more’
Eggers, now 73 and of Sweet Home in central Oregon, had been diagnosed with pulmonary hypertension in 2007. The serious condition involves increased blood pressure in the lungs, and often happens in patients with poorly performing hearts. Medications mostly managed his symptoms, but his heart started to hurt when he was cutting up and hauling trees that fell on his 8-acre farm during a 2017 ice storm.
The faulty valve made it difficult for his heart to pump blood, which made it challenging for oxygen to move through his body. Eggers was frequently dizzy and exhausted as a result.
The normally active retired electrical supervisor relied on his wife, retired nurse practitioner Janet Eggers, to care for the many animals on their hobby farm. He confided in her that he didn’t think he could live much longer as he was.
But in November 2019, he learned he was eligible to participate in a new study, the CLASP II TR clinical trial, which is evaluating a new, minimally invasive device that repairs tricuspid heart valves without open-heart surgery. On Dec. 11, 2019, Eggers became the trial’s first participant to receive Edwards Lifesciences’ PASCAL transcatheter valve repair system.
Eggers had a severe case of a leaky tricuspid valve before, and now only has a mild case. A month after the procedure, Eggers feels energetic again. So much so that his wife jokingly says he apparently has enough energy to be occasionally cranky. After Eggers completes about six months of outpatient cardiac rehabilitation, the couple looks forward to returning to discovering new wildflowers during wilderness hikes.
“I feel like I can do so much more thanks to this procedure,” Eggers said. “I am grateful and fortunate that OHSU has people with the expertise needed to provide me this care. It’s all fallen into place so beautifully.”