Josephine’s Story: A New Lease on Life at 86

Prior to her aortic valve replacement at Saint Vincent Hospital in October 2015, Josephine Horning, who recently celebrated her 86th birthday, had been experiencing some shortness of breath and noticed that she tired easily. That led to her diagnosis of critical aortic stenosis, a degenerative heart disease. Her aortic valve wasn’t functioning properly because of plaque built up around it. The result was that her heart could no longer reliably push blood in the body’s largest artery, the aorta.

“A Good Experience”

“I had two incredible doctors at Saint Vincent,” Josephine says. “I liked Dr. Robert Bojar (cardiothoracic surgeon) and Dr. Joseph Hannan (cardiologist) immediately. Each was straightforward and had a great sense of humor. I trusted them completely and put myself in their hands.”

The traditional solution for aortic stenosis is open heart surgery to replace the valve. But, even for a moderately healthy patient, the procedure poses a significant risk. Open heart surgery involves cutting through the breastbone and opening the heart while using a heart-lung bypass machine and a ventilator to maintain circulation and breathing. For severely ill patients, or those too frail due to age, the surgery simply can’t be done.

Fortunately for Josephine and others with aortic stenosis, Saint Vincent Hospital now offers an alternative procedure to replace the aortic valve called transcatheter aortic valve replacement, or TAVR. Both Drs. Bojar and Hannan recommended TAVR for Josephine. The less-invasive procedure uses a catheter inserted into the patient's groin to replace the diseased valve.

Saint Vincent has added a variation to TAVR — one that made a huge difference in Josephine’s recovery. Saint Vincent now performs the surgery under moderate sedation instead of general anesthesia, to avoid using invasive monitoring devices. Saint Vincent’s surgeons use a surface echocardiogram (imaging that uses ultrasound) to monitor the catheter’s progress instead of a camera, which requires a second line inserted into the body. The U.S. Food and Drug Administration approved performing TAVR with moderate sedation last year.

A Tremendous Improvement

Josephine had previously undergone several unrelated surgeries using general anesthesia. “Each time, when I woke up after the procedure, I was sick, groggy and confused, and it took months for my body to recuperate,” Josephine says. “After the TAVR at Saint Vincent — without general anesthesia — I felt great when I woke up. It was much different. I felt fresh and alert, like I had just had a nap. I was only in the hospital for 48 hours. And 24 hours later, I was approved to drive.

“My treatment at the hospital was very good; I can’t say enough about the nursing,” she continues. “I would definitely recommend Saint Vincent to my family and friends, and if they needed the same type of operation, I would definitely recommend Dr. Bojar and Dr. Hannan. They’re two great men.

“Since the TAVR, I’ve felt really good. The new valve is functioning well. I don’t get tired out; it’s like a whole new lease on life.”