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Procedure, ‘miraculous recovery,’ get Ayden man back on the golf course; new, smaller heart valve will help others

August 11, 2015 by Kathy Neal

GREENVILLE, N.C. – Chester “Gene” Page, 78, hadn’t seen a doctor in more than 12 years, but last December, the Ayden resident didn’t have a choice. A worn-out heart valve led to sudden and extensive heart failure, requiring life-saving surgical intervention at Vidant Medical Center’s East Carolina Heart Institute (ECHI). 

After a successful transcatheter aortic valve replacement (TAVR) at ECHI, Gene has been back out on the golf course and enjoying time with his grandchildren. TAVR is much less invasive than open-heart surgery. It involves only small incisions and a thin tube through which a new heart valve is inserted. 

This week, ECHI became one of the first few heart centers in North Carolina to begin using a new smaller, easier-to-insert valve for TAVR patients. 

“In eastern North Carolina, our population has more severe health challenges than many other areas,” said Van Smith, senior vice president at Vidant Medical Center (VMC), who works with cardiovascular services. “TAVR offers a good option for people who once would have been considered poor candidates for heart-valve replacement, due to age or health status. Under the right circumstances, TAVR can bring a significant improvement to quality of life and reduce more costly care for heart-valve problems that are not repaired.”

Gene’s experience began with “indigestion” after supper one night. Nothing helped, and by 6 a.m., the normally energetic retiree complained of severe fatigue and difficulty breathing. His wife, Judy, and their daughter, Melody Byrum, a nurse at VMC, insisted he see a doctor. After a brief stop at the doctor’s office, they went to VMC’s Emergency Department.

Tests showed he had a major problem with one of the heart valves that helps regulate oxygenated blood flow from the heart to the body. Only 30 percent of oxygenated blood was getting through, and Gene was critically ill as a result.
Both Judy and Melody were shocked at how rapidly Gene’s condition deteriorated. Judy recalls Melody saying, “But Mama, he just played golf yesterday.” Gene was put on an external heart pump for nearly a week before surgeons felt he was ready to undergo TAVR. “We didn’t know if he would make it through valve surgery,” Judy said, “But Dr. Kypson encouraged us to try.” 

Dr. Alan P. Kypson, a cardiothoracic surgeon affiliated with ECHI and ECU’s Brody School of Medicine, performed the procedure.

TAVR is becoming an increasingly practical option, especially for older patients. “We are on target for 80 to 90 TAVR cases this year, which by national standards ranks us as a large-volume program,” said Tamara S. Goda, a cardiothoracic nurse practitioner and administrator responsible for clinical operations and program development at ECHI. “Now, with an even smaller valve and delivery system available, we will be able to offer this procedure to a larger group of patients, leading to shorter recovery times and improved patient satisfaction.” 

Gene got his new valve a few days before Christmas, and his condition improved dramatically after that. Recovery has been time-consuming and sometimes difficult, Judy said, but he, “didn’t really complain until toward the end [of his hospitalization], when he was ready to get back out on the golf course.” He returns regularly to VMC for follow-up care, including check-ups and monitoring of his Coumadin level, a blood thinner.

“Gene has made a miraculous recovery with the help of excellent nursing care, the heart pump and TAVR,” said Dr. Ramesh Daggubati, director of cardiac catheterization labs at ECHI and clinical professor in the cardiovascular sciences department at ECU’s Brody School of Medicine. “VMC has been at the forefront of cardiovascular research, including TAVR, to benefit our patients and now we are able to do most procedures less invasively with smaller devices.”

Melody and Judy believe Gene received exceptional care, especially from the nursing staff, nurse practitioners and Drs. Kypson and Daggubati, they said. 

As for Gene, he says he is thankful for what happened. Even more important to him, though, is that his golf game is nearly back to normal. “I lost 50 pounds and lost 50 yards on my drive,” he said, but his game is now “about where it was before I got sick.” 
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