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Innovative procedure provides life-saving treatment for heart valve disorder

  • January 14, 2021
  • Number of views: 3570
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Physicians using modern technology in heart surgery

Modern medical technology improves heart care

Booker Fisher, an 86-year-old former Marine has experienced more than his share of heart problems for over 30 years. After serving for 24 years – including in the Korean War – he worked as an experimental flight tester at McDonnell Douglas.

In 1989, Booker started experiencing symptoms of heart disease and had his first heart attack. “I had just gotten off of work, and started to feel strange,” he shared. “It felt like an elephant was standing on me.”

Since that moment, the veteran has endured three open heart surgeries, “Us Marines are tough,” he added. Between those procedures, Booker went back-and-forth for regular cardiology checkups, and continued to experience occasional symptoms.

Booker was diagnosed with tricuspid regurgitation (TR), a common disorder in which the valve between the right heart chambers — right ventricle and right atrium — doesn’t close tightly, allowing blood to flow backwards from the right atrium to the right ventricle during each heartbeat.

Patients with TR often experience symptoms of right-sided heart failure and right-sided congestion, including shortness of breath, swelling, frequent hospitalization, fatigue, weight loss, and liver and kidney failure.

Although Fisher was 86 years old, Washington University interventional cardiologist, Dr. Alan Zajarias found he was physically fit enough for a transcatheter tricuspid valve replacement (TTVR). Performed through the femoral vein in the leg, this non-surgical, catheter-based procedure accessed the femoral vein through an incision in the groin to deliver a new tricuspid valve into the heart to treat the regurgitation.

Fisher’s TTVR procedure, performed Sept. 17, 2020 at the Washington University and Barnes-Jewish Heart and Vascular Center, was just the third such procedure completed worldwide and required a compassionate-use designation from the FDA due to an absence of ongoing clinical trials. This designation can be requested by medical teams when a patient’s condition is serious or life-threatening and alternative treatment options are not available.

Led by Dr. Zajarias and Washington University cardiac surgeon Hersh Maniar, MD – the novel procedure performed by the heart valve team helped Fisher go from severe tricuspid regurgitation to no regurgitation in a short amount of time.

“Booker and other patients with severe tricuspid regurgitation have very limited treatment options,” says Dr. Zajarias. “Open heart surgery was the only other option for Booker and he was not a candidate due to his high risk, prior heart surgeries.”

He also credits his care team at Barnes-Jewish Hospital with his successful outcome. “Those are wonderful, talented people,” he says. “They took and are still taking good care of me. I give them five stars!” After his recovery, Booker is looking forward to spending quality time with his three children, 12 grandchildren and 9 great-grandchildren.

The Heart & Vascular Center was also first in the St. Louis Metropolitan area to perform the transcatheter aortic valve replacement (TAVR) via transapical approach in 2008.  The team also first performed the transcatheter mitral valve repair via a transfemoral approach during a 2006 clinical trial.  The center provides multidisciplinary evaluation to patients with simple and complex valve disease and enrolls them in the latest clinical trials.

Learn more about our Heart Valve Team

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