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Sanford team replaces heart valve with new method

Alice Braniff, 87, recently received a new heart valve using a new surgery technique that allowed for a faster recovery. David Samson / The Forum

FARGO - Just months ago, doctors here wouldn't have been able to repair a narrowing valve in Alice Braniff's heart.

The 87-year-old woman likely wouldn't have survived open-heart surgery to replace the valve.

Without a new valve, the odds suggest she more than likely wouldn't have survived two more years.

But Braniff was one of the first patients in the area to receive a new heart valve using a recently approved procedure that doesn't require major surgery.

"I feel better," she said. "I've got more pep, more energy. My appetite has improved greatly."

On Aug. 24, a Sanford Health team led by Dr. Thomas Haldis, a cardiologist, inserted a catheter in her groin and threaded it all the way to her heart to replace the ailing valve.

"It's a very simple plumbing problem," Haldis said. But replacing a bad heart valve is anything but simple, especially if the patient is elderly and frail.

"A few months ago, we were patting them on the leg and saying, 'I'm sorry,' " Haldis said, referring to patients whose delicate health made their condition inoperable.

"These are for people who are sort of at the end of their rope," he said. "For lack of a better term, it's the coolest cardiac procedure we do now in the cath lab. It's awesome."

Braniff was the fifth patient at Sanford Medical Center in Fargo to receive a new heart valve using the catheter procedure, which was approved less than a year ago by the Food and Drug Administration.

Fellow cardiologist JoEllen Kohlman-Petrick in Fargo and other Sanford colleagues in Sioux Falls, S.D., also have been trained to do the procedure.

The two Sanford medical centers are among about 100 heart programs in the country qualified to perform the procedure.

Without the procedure, called a transcatheter aortic valve replacement, the only alternative would have been to perform conventional surgery. That requires cracking open the rib cage and using a heart-lung machine.

To be approved for the catheter procedure, patients are carefully screened to determine if they are good candidates. They have to be deemed healthy enough, and have blood vessels large enough to accommodate the catheter.

"This is not a no-risk procedure," Haldis said. "There are significant risks."

Of the first seven patients to receive the procedure at Sanford Medical Center in Fargo, all very elderly, two died, both in their 90s, he said.

In the FDA study, 70 percent of patients who received the valve were alive after one year, compared to 50 percent who received alternatives.

For the majority who survive with a new valve, the improvement is significant. "If you have a procedure that goes well," Haldis said, "the people spring back."

That was the case for Braniff. Her decline had been gradual, but her improvement following the valve replacement was sudden.

"I was bouncing around like crazy," she said. "I felt so good. It really was amazing."

Before her heart valve problem was diagnosed, "I didn't realize I had a heart problem," she said, noting she had been getting treatments for multiple myeloma, a cancer involving the white blood cells, now in remission.

Braniff has been going to cardiac rehabilitation therapy for three weeks, sessions she will continue for a time. And she is lengthening her walks.

"I'm happy I went through with it," she said of the procedure. "I feel good so far."