by Dawn Brazell
Public Relations

The residents at Bishop Gadsden better watch out. Henry Brawner, 91, is back to the poker table and more like his old self thanks to a transcatheter aortic valve replacement procedure that was done March 29.

MUSC was the first in South Carolina to perform the implant, done through a minimally invasive procedure that is now a new option for patients previously considered too sick to undergo traditional valve replacement surgery. The procedure can be done instead of traditional, open-heart surgery.

Brawner said his results have been very close to a miracle and he has been amazed by the transformation in his energy and activity levels following the procedure by Drs. Daniel H. Steinberg and John S. Ikonomidis. Having recovered quickly, Brawner said he's glad he opted to try the new procedure. He has enjoyed resuming a more active lifestyle and looks forward to celebrating his 70th wedding anniversary in December.

Henry Brawner (right) takes a stroll with his wife, Francis. He likes that he can be more active now since his TAVR procedure.

Ikonomidis, a cardiothoracic surgeon and director of the South Carolina Heart Valve Center at MUSC, said the new valve enables doctors to treat a new population of patients with aortic valve disease. "Since it involves a minimally invasive procedure, TAVR allows us to operate on patients who are too frail or sick for open valve replacement surgery."

The good news for patients is that the Centers for Medicare and Medicaid Services decided May 1 to reimburse clinicians for transcatheter aortic valve replacement (TAVR) in inoperable patients with severe aortic stenosis. That will open the door for more of these procedures to be done.

TAVR involves an artificial valve being threaded through a small incision in the leg, and then guided up to the heart through the arteries. A small inflatable balloon on the tip of the catheter places the artificial valve in place at the aortic opening, replacing the natural heart valve. The device is made from cow tissue and polyester supported by a steel frame.

Up to 1.5 million people in the U.S. suffer from aortic stenosis, a narrowing of the aortic valve, which forces the heart to work harder to pump blood and can lead to heart failure, blood clots and sudden death. Without an aortic valve replacement, more than half of patients diagnosed with aortic stenosis would die within two years after the onset of symptoms, according to the FDA.

"We've been performing open-heart valve replacements in patients for decades, and for those patients, the surgery can be life-changing—significantly improving and prolonging their lives," said Ikonomidis. "Now we can offer new hope to some of our sicker valve patients, providing them with a chance to live longer and feel better, thanks to this new procedure."

Brawner and his wife, Francis can attest to that. His wife said her husband was facing the prospects of a motorized wheelchair, but now he's back to all his usual activities, including helping her cook. "I was all for it because I knew he was going downhill."

Meanwhile, in addition to his poker games, Brawner said he's back to shopping with his wife, using the gym and just being more active in general. He decided to try the new procedure because he was so fatigued and short of breath all the time.

"I was having a hard time just getting out of bed without pushing up with my hands. Now I can just pop up. It's a remarkable difference."