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MultiCare offers new heart valve procedure

Posted on Feb. 18, 2015 ( comments)
Rocco Celletti
Rocco Celletti, 79, pictured with wife Beverly, was back to gardening just six weeks after TAVI surgery 
At 79, Rocco Celletti still runs a forklift and lifts heavy equipment as the owner of a Tacoma printing equipment business. 
“I definitely enjoy being active,” Celletti says. “I’m not a lazy person.” 
But in 2014, the resident of Olalla, in Kitsap County, noticed he was feeling short of breath walking up stairs and fatigued from other everyday activities.
He was diagnosed with severe aortic stenosis, a disease of the heart valves in which the opening of the aortic valve narrows and obstructs blood flow to the rest of the body. 
The remedy is a valve replacement. However, because of his age and the fact that he’s already had bypass surgery, surgeons were reluctant to perform traditional open heart surgery on Celletti. 
Fortunately, MultiCare Health System could offer another option for the energetic grandfather of eight. 

A MultiCare first 

Celletti was the first MultiCare patient to undergo a transcatheter aortic valve implantation (TAVI). The innovative procedure, which replaces the damaged heart valve, has been available to patients since mid-May 2014.
A conventional valve replacement typically involves a sternotomy, or surgically opening the chest, and sometimes the use of a heart-lung bypass machine. 
However, TAVI requires neither of these. Instead, the surgeon makes a smaller incision in the chest or groin; a catheter is then used to deliver a collapsible replacement valve, which is expanded inside the old aortic valve. 
MultiCare is the only health system in the South Sound to offer the TAVI option to patients. Multiple MultiCare cardiologists, cardiothoracic surgeons and vascular surgeons are trained or are undergoing training to perform the procedure, including Drs. Allen Graeve, Kurt Kinney, Vinay Malhotra, Kingson Momah, Dennis Nichols, Felix Vladimir and Devendra Vora.

TAVI reduces risk

TAVI is offered to patients for whom open heart surgery is deemed too risky. Candidates are often in their 70s or 80s, or they may have experienced other health problems, such as stroke, cancer, or chronic obstructive pulmonary disease, all of which make TAVI a better option. 
“TAVI was devised as a way to help patients considered too sick or too old for conventional surgery,” says Dr. Allen Graeve, a cardiothoracic surgeon and medical director of MultiCare Cardiothoracic Surgical Associates. 
In Celletti’s case, Dr. Graeve says the patient’s previous open heart surgery meant a second procedure would be more difficult and higher risk. 
“He was vetted by two surgeons, who said they wouldn’t want to operate,” he says. “That’s when we knew we could offer him TAVI.” 

TAVI means shorter recovery

Because surgeons don’t need to open the chest or stop the heart and use a bypass machine, recovery from a TAVI procedure is often much quicker. 
Celletti spent about six weeks recovering from his quadruple bypass eight years ago. By contrast, he had his TAVI surgery on a Tuesday and was mowing his lawn by Friday. 
“It’s definitely better than having your chest opened up,” Celletti says. “I had no pain.” 
Dr. Graeve says even patients who take longer to recover due to illness or age benefit from the new procedure. They have less stress on their system during and post-surgery and are at lower risk of complications, he says.
Six weeks after his TAVI surgery, Celletti says he’s feeling great. He’s gardening, working and helping his wife recover from recent knee surgery. 
He can breathe easier and has more energy than he’s had in months. “I can even run up the stairs,” Celletti says.
This story was originally published in August 2014 and updated in February 2015.  

Posted in: Cardiac

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