Southwest Florida's Health and Wellness Magazine Health and Wellness Articles
By Heidi Smith, Contributor
Ellen Hofmann already knew she had a heart condition, so when she and her husband moved to Venice, she looked for a cardiologist. She believes she’s alive today because she didn’t delay following up on her care.
“I found out in 2018 that one of my carotid arteries was 90 percent blocked (by plaque), then later, my aortic valve – which I already knew was a potential concern – became dangerously narrowed,” said the 71-year-old retired teacher/librarian. “My father died of a stroke when I was 13 years old, so when I started having shortness of breath, I was very concerned.”
On the recommendation of a neighbor, Hoffman consulted with James Landis, M.D., an interventional cardiologist with Gulf Coast Medical Group. Dr. Landis reviewed her case with John Galat, M.D., a cardiothoracic surgeon also with Gulf Coast Medical Group. Dr. Galat founded and directs the heart program at Venice Regional Bayfront Health. The physicians determined the immediate priority was the carotid artery, and the aortic valve could be monitored.
In 2018, Dr. Galat performed surgery on Hofmann’s carotid artery to “clean out” the plaque. He opened the carotid artery, removed the plaque, and then placed a patch along the incised area to act as a pleat.
“Imagine sewing two pieces of fabric together. If you just sew the edges together, you have to overlap the edges, so you can narrow the artery,” Dr. Galat explained. “Using the patch material, we actually widen that area of the artery.”
“Although I had had medical procedures before, I was anxious,” Hofmann related. “But Dr. Galat has a very steady, easygoing, reassuring manner that gave me comfort. I knew I was in the right hands. On the morning of the procedure, Dr. Galat and his team surrounded me and gave me their strength. It was a very emotional moment for me.”
Hofmann’s recovery from the carotid surgery proceeded normally. Then in 2020, her aortic valve had narrowed to the point that surgery was called for.
“Fortunately, medical science has advanced to a level where we have a number of options for addressing aortic valve stenosis to prolong and enhance the quality of patients’ lives,” Dr. Galat said. “Our interdisciplinary heart team at Venice Regional performs the same procedures – from open heart to minimally invasive – that are done at the largest institutions.”
“Aortic stenosis is a mechanical problem; it can’t be solved with medication,” Dr. Landis explained. “To resolve Mrs. Hofmann’s aortic valve condition, we presented a number of surgical options, including a minimally invasive procedure called transcatheter aortic valve replacement (TAVR).”
TAVR surgery involves insertion of a delivery system into an artery, typically in the groin area. The interventionalist and surgeon guide the delivery system to the heart to place the new valve, which is made from heart tissue from a cow. It’s the same material used for valves in open heart surgery, but the TAVR valve is designed to expand inside the existing valve.
In 2019, TAVR was approved for all patients with severe aortic stenosis.
“Before TAVR, the only option was open heart surgery to replace the valve. Especially with patients of more advanced years, open heart presents greater risk and a much longer recovery period,” Dr. Landis explained.
Benefits of TAVR compared to open heart include shorter procedure and hospital stay times, relief of symptoms almost immediately, improved heart function, faster recovery, and less medication. Patients quickly experience improved energy and easier breathing. Patients who undergo this procedure also experience a significant decrease in all-cause mortality compared to traditional valve surgery.
“I knew I wanted to go forward with the TAVR, and given my experience with Dr. Galat, Dr. Landis and all the team, I was confident they would be successful for me. Both doctors said, ‘You can go anywhere you want to go (for the procedure).’ My husband and I said without hesitation, ‘We’re going with Dr. Galat.’”
Hofmann’s TAVR surgery was performed in January 2021 by Dr. Galat and Edmund Bermudez, M.D., who is an interventional cardiologist with Gulf Coast Medical Group and oversees the TAVR program at Venice Regional.
“The exciting thing is that patients feel an immediate benefit when the aortic stenosis is relieved,” Dr. Galat said. “Instead of pushing blood through a small opening, the heart can push blood flow through a much larger opening. The ultimate benefit for Mrs. Hofmann is that her risk for sudden death decreased.”
“I watched a video that prepared me for the procedure and how I might feel physically after surgery. Everything was exactly how they told me it would be,” Hofmann said. “I came home the day after surgery. Within a week I was walking on the beach. Two months later, I was pretty much back to normal. I would recommend Venice Regional’s heart team to anyone. You feel confident and consoled. You feel they have compassion for you.”
How healthy is your heart? Find out in just five minutes. Take a free heart risk assessment at GulfCoastMecicalGroup.com/HealthyHeart or call 844-406-1007 to schedule an appointment today. In-person and telehealth visits are available.