Heart surgery

OH doctor performing a procedure that once required open heart surgery | Characteristics


As part of its efforts to focus on cardiology and heart-related procedures and treatments, Owensboro Regional Health Hospital recently launched its Structural Cardiology program.

Through the program, under the leadership of Dr Ashish Rastogi, the hospital began performing catheter aortic valve replacement (TAVR) procedures to treat patients with aortic stenosis.

Rastogi, an interventional cardiologist with specialized training in performing TAVR and other cardiac procedures, said bringing the procedure to Owensboro allows patients who need it to receive services close to home instead. than going 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 like the perfect situation because they wanted to start a program,” he said. “They have a hospital that has top-notch facilities and can really provide these services to the community; they just needed a doctor to do it.

Rastogi started performing TAVRs in August this year, having done nine so far with 15 patients scheduled in the next month or two.

Since the start of the program, 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 the blockage of the main valve.

A TAVR replaces a narrowed aortic valve that doesn’t open properly – 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 be more widely used about five years ago.

Before that, he said aortic stenosis is treated with open heart surgery, which is much more invasive and requires a longer recovery time.

Additionally, he said, open heart surgery is not as ideal for patients who might have underlying medical issues that could make them more at risk for an invasive procedure with a difficult recovery process. .

These underlying conditions can include lung disease, COPD, people who have had a previous stroke, are debilitated, or have several underlying medical conditions.

“Before 10 years ago, the only way to treat aortic stenosis was through surgery,” he said. “Now the standard of care is having a TAVR for aortic stenosis for the majority of patients instead of having surgery. “

TAVRs, he said, are not only less invasive than open heart surgery, but have a shorter recovery time. While open heart surgery may require a week or more of recovery in the hospital, the TAVR procedure typically takes about an hour with a recovery process of a day before the patient can be discharged.

Rastogi said aortic stenosis is actually quite common in about one in eight people aged 75 and over who have some level of the disease.

“It’s very common,” he says. “When severe, it can restrict blood flow to the whole body.”

However, he said, many of those people who experience symptoms of the disease might not even be examined, as the symptoms are usually mistaken for regular signs of aging.

Symptoms of aortic stenosis can include fatigue, lightheadedness, lightheadedness, chest pain, and fainting.

“They don’t recognize that they actually have a valve problem so a lot of it goes unrecognized and the majority of patients never see a doctor and never find out,” he said. . “We know that when a person has severe aortic stenosis blockage to this degree and shows symptoms of it, they don’t do very well in the long term.”

About one in five people with the disease who don’t receive treatment, he said, live no more than five years and 50% could die after two years of symptoms.

“It’s really important to recognize it and deal with it,” he said.

Bringing the procedure, along with other heart-focused treatments, to Owensboro, said Rastogi, creates better access for individuals to seek care and consultation locally if they have symptoms or have concerns, rather than to live with a disease that is treatable.

“Bringing that to the community here, I think, is really important because it’s a procedure… and not having to leave their community in Owensboro and have to go to Nashville or Louisville or somewhere within a few hours,” he said. -he declares. being able to get this… procedure more locally and have a follow-up here is much better for them.

TAVR is the latest in a series of innovations within OH’s heart program over the past year. The OHRH also expanded its cardiac imaging and electrophysiology capabilities, renovated the cath lab, and partnered with Cincinnati Children’s to provide pediatric cardiology services.