The Heart of the Matter

Enloe Offers Innovative TAVR Procedure

The game-changing Transcatheter Aortic Valve Replacement (TAVR) is offered at Enloe Medical Center’s Structural Heart & Valve Center performed by a pioneer in the field — giving heart patients new hope.

Until recently, open-heart surgical valve replacement was the only option for the treatment of aortic valve disease, a condition in which one of the major heart valves doesn’t work properly. If patients were too old or too frail, they were not candidates for surgery and no other treatment options existed. That’s a thing of the past.

“We have a patient who had her TAVR at the age of 100. She is now 101 and going strong,” said Shailesh Nandish, M.D., Medical Director of Enloe’s Structural Heart & Valve Center. “… I have seen this procedure make a remarkable difference and improvement in quality of life with less risk for all patients suffering from aortic valve disease, especially for elderly patients who had no good treatment options.”

Launched in 2020, Enloe’s TAVR program was the first in Northern California, north of Sacramento. Before the program arrived in Chico, Nandish was already heavily involved with the new leading-edge approach beginning in 2012, when the first TAVR clinical trial began in the United States.

“I have been very closely involved in the evolution of Transcatheter Aortic Valve Replacements and an active researcher and investigator in various U.S. clinical trials leading to recent FDA approval of the device in all eligible patients,” he added.

Better Outcomes

With the North State’s population aging, having this program close to home is important. The majority of Enloe’s TAVR patients are 65-95 years old — and many are older than 90. According to Nandish, these patients do remarkably well with this minimally invasive procedure.

“TAVR has made such an impact on people’s lives,” Nandish said. “I am excited that we have been able to provide that care here at Enloe Medical Center with outcomes better than the national average.”

So far, more than 100 TAVR procedures have been performed at Enloe. Anyone with aortic stenosis is a potential candidate. A significant portion of the candidates will likely have COPD, coronary artery disease, kidney disease and diabetes. Folks who have had previous radiation to the chest, extensive calcium around the aorta that would make open-heart surgery difficult and those who are frail or have a physical disability that would make recovery from open-heart surgery challenging can also benefit from this approach.

When it comes to caring for patients, it’s a team effort that involves Cardiac Cath Lab caregivers, nurses, an echocardiography team, anesthesiologists, cardiologists, cardiothoracic surgeon Miguel Puig, M.D., and Structural Heart Program Coordinator Emma Denz, RN. These caregivers are dedicated and committed to providing quality care with good outcomes.

"I went to the doctor a week later and the nurse was flabbergasted,” said James Nicholls, a TAVR patient. "She said she could hardly keep up with me."

Better Quality of Life

Denz adds that patients really do notice a difference quickly. Many are thrilled they no longer have to gasp for air.

This was the case for James Nicholls. At 82 years old, he was the 100th TAVR patient. He was able to return home after just two days — and immediately noticed he was no longer short of breath and that his strength returned.

“I went to the doctor a week later and the nurse was flabbergasted,” Nicholls said. “She said she could hardly keep up with me. I would absolutely recommend them. I was so impressed with Dr. Nandish and Emma, and felt I was in very good hands.”

“The only objective of our TAVR program is to enhance the quality of life of our patients by providing compassionate, quality care with excellent outcomes close to home,” Nandish added.

And this is just the beginning. Nandish hopes to expand the services offered at the Structural Heart & Valve Center to include other leading-edge heart procedures to provide more minimally invasive treatment options with excellent outcomes.

To learn more about TAVR and Enloe’s Structural Heart & Valve Center, visit www.enloe.org/tavr.