New heart surgery means a new lease on life

By Rosalie Rayburn / Journal Staff Writer
Tuesday, May 22nd, 2018 at 12:02am

ALBUQUERQUE, N.M. — Bill Hamilton is looking forward to trout fishing on the San Juan River this summer.

For the past couple of years, a failing heart valve sapped his energy, leaving him stuck on a recliner, gasping for breath.

That all changed in March when a medical team from New Mexico Heart Institute performed a new type of heart surgery to replace the mitral valve in his heart. The surgery uses a catheter inserted in the groin or chest and guided to the heart to insert the replacement valve.

As of early April, Hamilton was one of only around 100 patients nationwide who had undergone the new procedure.

“We’re excited to bring this to New Mexicans,” said Dr. Kevin Richardson, a cardiothoracic surgeon at New Mexico Heart Institute and a member of Hamilton’s surgical team.

From left, Rachel Deaton, structural heart coordinator, Dr. Kevin Richardson, Linda Miller and her partner Bill Hamilton, and Dr. Geoffrey Kunz.

Richardson said the technique is less invasive than open heart surgery and can be used for patients who have previously had a valve replaced, but are now experiencing the fatigue and shortness of breath that indicate the replacement valve is failing.

The catheter technique has been used for several years to replace the heart’s main valve, the aortic valve, which allows blood to flow from the heart to the body, said Richardson. But the FDA approved using the technique for the mitral valve only in 2017. The mitral valve, which prevents oxygenated blood from flowing backward into the lungs, is a more complicated structure than the aortic valve, Richardson said.

Patients typically receive the first replacement valve because of a birth defect or a disease. Nationally, between 35,000 and 37,000 patients had this type of mitral valve replacement in 2016, according to Dr. Geoffrey Kunz, another New Mexico Heart Institute physician on Hamilton’s surgical team.

But those replacement valves, be they mechanical or tissue from a pig or cow, typically last only 10-12 years.

“There’s a whole cohort of patients out there where the clock is running down,” said Kunz.

Until recently, Kunz said, patients would have to undergo another open heart surgery to insert another replacement valve. But if they were too ill and too frail to risk such a procedure, there were no other options.

As Hamilton’s replacement valve failed, he’d visited a local emergency department more than a dozen times because he couldn’t breathe. At one point, his heart began beating erratically, up to 180 times a minute. Early this year, tests revealed the mitral valve problem. Shortly after, he was so ill he was hospitalized.

The New Mexico Heart team performed the transcatheter mitral valve surgery on March 19 at the Heart Hospital of New Mexico at Lovelace Medical Center.

For Hamilton, the surgery has meant a new lease on life.

“It’s amazing how good it feels to breathe,” he said, “I’ll be back on the San Juan fishing before long, catching big browns and rainbows.”