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Published on February 24, 2015

New Heart Valve Replacement Option Benefits High-Risk Patients

MU Health Care first in mid-Missouri to offer less invasive approach

COLUMBIA, Mo. ― A new less invasive procedure offered by University of Missouri Health Care’s comprehensive heart valve team now can benefit patients who were previously considered too high-risk for a traditional repair.

Johnnie Martin of New Franklin, Missouri, was one of the first people to benefit from the procedure. Martin had aortic stenosis, a narrowing of the aortic valve in his heart. His condition prevented the valve from fully opening, which reduced blood flow to his body. His symptoms caused a multitude of health problems that affected his daily life.

“While I certainly had pain in my chest, it was the shortness of breath and weakness that affected me most,” Johnnie said. “I pretty much gave up everything I used to do because I didn’t have the strength. Being on oxygen from here on out was the next step, and I didn’t want that.”

As is usually the case with spouses, Johnnie’s wife, Beryl, also was affected by his condition.

“We live very close to the Katy Trail,” Beryl said. “We used to take these long walks just about every day. It’s been three years since his health declined to the point that we haven’t been able to enjoy our walks. I want us to get back out on that trail.”

Ajit Tharakan, MD

Ajit Tharakan, MD

Although heart-valve replacement offers an improved quality of life for most aortic stenosis patients with severe symptoms, often their age and additional health issues prevent the traditional repair.

“Many high-risk patients with severe symptoms like Mr. Martin benefit from an aortic valve replacement,” said Ajit Tharakan, M.D., assistant professor and chief of the Division of Cardiothoracic Surgery at the University Of Missouri School Of Medicine and a cardiothoracic surgeon at MU Health Care. “However, their co-morbid conditions prevent them from being a candidate for a traditional open replacement procedure.”

“The new procedure is called a transcatheter aortic valve replacement (TAVR),” Tharakan said. “With this procedure, we are able to repair the damaged valve using a transcatheter approach, a less invasive method that does not require open heart surgery.”

Arun Kumar, MD

Arun Kumar, MD

“TAVR allows our team to replace the dysfunctional valve without having to remove the old one,” said Arun Kumar, M.D., assistant professor of clinical medicine in the Division of Cardiovascular Medicine and a cardiologist at MU Health Care. “We use a catheter that we insert through an artery in the groin. We then thread the catheter to the heart and position the new valve, where it is held in place. For those patients with arterial blockages that prevent placement through an opening in the groin, we can still replace the valve using a small incision between the ribs to bypass the blockage. Either method puts much less stress on the patient and allows us to do repairs that otherwise could not be done.”

Kumar emphasized that although less invasive, TAVR is reserved for patients who are considered high-risk and is not for all heart-valve replacement candidates.

“The open procedure is still the gold standard for most patients,” Kumar said. “However, TAVR is an effective option to improve the quality of life for patients who otherwise have limited choices for repair of their aortic valves.”

For Johnnie, who underwent the procedure in December 2014, the new less-invasive procedure already is paying off.

“Oh, I can definitely tell a difference,” Johnnie said. “I am completely off oxygen and am able to walk on my own again. I can’t walk for too long yet, but I’m going to get there.”

“We’ll be back out on the Katy trail, I know it,” Beryl said. “It’s going to happen.”

To learn more about TAVR and MU Health Care’s comprehensive heart valve team, please visit

Click here to download a high-resolution photo of Arun Kumar, MD.
Click here to download a high-resolution photo of Ajit Tharakan, MD.