When he learned a valve in his heart needed to be replaced, 81-year-old Robert Kraus was totally against it. He was adamant doctors would not perform an open-chest procedure on him. Not at his age.
Fortunately for Kraus, he landed at the right place at just the right time and became the first patient at the University of Kentucky to receive a TAVR – a Transcatheter Aortic Ventricular Replacement device.
“One of the things having to do with having your chest opened – when you get to be my age, most of the people you know who have it done don’t do very well,” said Kraus who himself is a doctor, a psychiatrist at UK. “I’ve met a lot of guys who didn’t do very well — they wind up depressed or demented, and it took them a year or more to recuperate. So I was against it.”
After learning of his patient’s insistence against open-heart surgery, Dr. John Gurley presented Kraus with an alternative – the new minimally invasive TAVR procedure. When Gurley told Kraus that he would be a candidate for the first such procedure done at UK HealthCare, Kraus agreed to the surgery.
“He had no hesitation,” Gurley said
TAVR is the latest addition to UK’s comprehensive catheter-based structural heart program, which began offering balloon valvuloplasty in 1985.
In a healthy heart, the aortic valve is able to open wide, allowing the heart to pump oxygenated blood to the body.
In aortic stenosis – Kraus’ diagnosis – the valve is unable to open adequately, resulting in an obstruction of blood flow from the heart chamber into the aorta. When the blood flow is obstructed, less oxygen is able to flow through, and patients can suffer from shortness of breath, chest pains or fainting episodes.
“I started to complain of dizziness and balance problems, and I felt nauseous all the time,” Kraus said. “I used to be very energetic. I found myself spending a lot of time just sitting in a chair.”
Kraus said he then began falling frequently – something he had never done before.
It was at that point that doctors pinpointed the problem to a valve in Kraus’ heart.
“The doctors said I was just going to get worse if I did nothing,” Kraus said. “When they told me about this new procedure, I said ‘we’ll do it’.”
During the minimally invasive TAVR procedure, a prosthetic valve is implanted within the diseased aortic valve using a catheter inserted through the groin area. Once in place, a balloon is inflated to open the valve. Almost immediately, the new valve starts working in place of the diseased valve, resulting in improved blood flow.
Within hours of his surgery, Kraus was talking and making jokes with doctors.
The day after his surgery, Gurley walked into Kraus’ room to find him reading a book on the psychiatric history of the Civil War.
“At that point, it was clear that his mental function was not compromised at all,” Gurley said. “The operation was an outstanding success.”
Kraus said part of the reason he had no hesitation in being the first to have this procedure at UK was because of the facility itself and his knowledge of the level of expertise at UK HealthCare.
“My feeling – my particular bias – is that the place to be is a place like this,” Kraus said. “The people here are trained and have the skills necessary to do these sort of procedures. That’s the advantage of a big academic medical center.
“The continuity of care here is unprecedented,” Kraus added. “This team is dedicated to performing these types of procedures. That’s all they do.”
Following the surgery, Kraus spent five days in the hospital before returning home, where his rehabilitation included physical therapy. Just a few days after returning home, Kraus celebrated his 82nd birthday.
“This is my birthday present,” Kraus said. “The new valve.”