NMMC-Tupelo heart team opens new territory

By Michaela Gibson Morris/NEMS Daily Journal

TUPELO – An 83-year-old Columbus man has a new heart valve, but surgeons didn’t have to crack his chest open to give him one.
With a team of three cardiologists, two heart surgeons and 22 other specialists, nurses and technicians at North Mississippi Medical Center-Tupelo, Jimmie Nelms became the first man in Mississippi to have transcatheter aortic valve replacement last week.
Nelms and many members of the surgical team reunited Thursday, just over a week after the groundbreaking procedure.
“We’re one of the first centers to perform this procedure outside of clinical trials,” said Tupelo cardiologist Dr. Murray Estess.
“Lucky No. 7,” added Tupelo cardiologist Dr. Barry Bertolet, noting that NMMC-Tupelo was the seventh center in the country to have the procedure.
Before the valve procedure, Nelms’ heart was having to work extremely hard to pump blood into the aorta – the main blood vessel leaving the heart – through a valve hardened with calcium deposits, a condition called aortic stenosis. He was short of breath and had difficulty walking, but because of other medical problems, he wasn’t a candidate for traditional valve replacement surgery, said Tupelo heart surgeon Dr. Vishal Sachdev. Now, he has near normal pressure readings around his heart, and he’s had a much quicker recovery than traditional valve surgery patients.
“I feel like a different person now,” Nelms said while his wife and daughter beamed at him.
In the transcatheter aortic valve replacement, a wire is guided through the arteries to the heart through a small incision in the upper thigh. Using a balloon, the hardened valve is opened to make room for the new valve. The artificial valve is crimped down to fit into the artery and guided into place, Estess said.
When the surgeons are satisfied with the placement, it is inflated with the balloon. The imaging equipment in the hybrid operating room is essential to checking and double checking through the procedure.
“It takes all of us together to make it work,” said Tupelo heart surgeon Dr. David Talton.
The procedure is possible because of the team approach to heart care and the technology in the hybrid operating room recently installed at NMMC. It takes the skills and the equipment used by both specialties to make the complex procedure a success.
“The most important part of the process is that we have a team,” Talton said.
Not everyone is a candidate for the minimally invasive procedure. Under current FDA regulations, only non-surgical candidates are eligible for the catheter procedure. Additionally, patients must have wide enough arteries to accommodate the catheter and valve. In Europe, where surgeons and cardiologists have used the procedure longer, most aortic stenosis patients over 70 are treated this way, said Bertolet.
“This looks like a promising procedure,” Bertolet said.

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