A heart surgeon who performed a revolutionary aortic valve replacement therapy on patients with heart valve failure undergoes the procedure himself.
No one was more surprised than Dr. Rick Dearman when he was diagnosed with severe symptomatic aortic stenosis, also known as heart valve failure. As a heart surgeon, he’d treated hundreds of people with the condition. But after noticing that he was more tired and out of breath than usual, his wife — an ICU nurse — laid her head on his chest one night while watching television and told him point-blank: You have a heart murmur.
“I was a typical man, and I said, ‘No, I don’t,’” Dr. Dearman said with a laugh. “But I listened to my chest with my own stethoscope — and there it was.”
In many ways, Dr. Dearman is lucky: Heart valve failure is sometimes referred to as the “silent killer” because the symptoms (primarily shortness of breath, chest pain, and dizziness) can be subtle — or nonexistent. But ignoring those symptoms can be deadly: Up to half of patients diagnosed with symptomatic severe aortic stenosis (sSAS) die within two years unless they undergo treatment.
Effective treatment for heart valve failure exists, including, for many, the less invasive transcatheter aortic valve replacement (TAVR) procedure. No one knows this better than Dr. Dearman, who has experienced heart valve failure and TAVR as a son, a surgeon — and a patient.
“The TAVR procedure is really pretty amazing,” he said. “I’d say in my career, this would qualify as a medical miracle.”
Fixable, not fatal
Heart valve failure is a condition where the leaflets or flaps in the aortic valve in the heart thicken and narrow, typically due to calcium buildup, allowing less blood to pass through. “These valves are designed like in a machine to regulate flow,” Dr. Dearman explained. “With heart valve failure, the main valve leading out of the heart into the aorta becomes stiff and doesn’t open properly. Pressure builds up and the heart begins to struggle with extra work and can begin to fail.”
Once that failure begins, you can reach a point where the heart is so weakened it cannot recover, so prompt treatment is paramount. But sometimes, these symptoms are so mild they are ignored, turning a fixable condition into a fatal one. “It happens slowly,” Dr. Dearman noted, “over a period of time. You compensate — you slowly change your level of activity and behavior during the day to accommodate what you feel.”
The impact of heart valve failure will only become more pronounced as the population ages. The disease becomes more severe with age, and it’s estimated that 20% of people over the age of 65 have heart valve failure — a population estimated to more than double in the next four decades. And about 10% of patients diagnosed may die within five weeks without treatment.
The good news is that replacing the affected valve is highly effective: Having the procedure within three months of diagnosis can result in a lower mortality rate and other negative outcomes.
The bad news is that heart valve failure is startlingly undertreated: A 2016 study found that approximately 60% of heart valve failure patients went untreated. Lack of treatment disproportionately affects older generations and other patient subgroups, including women and people in communities of color, who are much less likely to undergo valve replacement.
Even when patients diagnosed with heart valve failure eventually undergo a valve replacement procedure, there are usually significant and life-threatening delays: An article published in 2023 found that between 2016 and 2022, nearly 40% of patients still had not been treated up to four years after their diagnosis.
An effective treatment
The reasons so many people with heart valve failure don’t undergo treatment stem in part from outdated attitudes among healthcare professionals. “Historically, heart valve failure was a very high-risk thing to treat,” Dr. Dearman explained. “When the first valves were implanted, the open-heart surgery was only performed when you had absolutely no other options.”
This is beginning to change, partly because of this effective, less invasive treatment option in the form of TAVR. Dr. Dearman’s first experience with TAVR was when it was performed on his 92-year-old father.
“I saw this firsthand with my father — he’s already had previous bypass surgery and a valve replacement — no one was going to do a third heart operation on a 92-year-old man who was in dire straits,” Dr. Dearman explained. “But after TAVR, it was literally a 180-degree turnaround. His heart activity was normal. That was very eye-opening.”
Since then, Dr. Dearman has performed the TAVR procedure about 300 times. The procedure involves placing a replacement valve on a catheter and inserting it through one of the femoral arteries on either side of the groin. The valve is positioned in the heart and expanded, pushing the native leaflets valve aside, and replacing the failing heart valve..
TAVR has been used for decades and can now even be used for patients who are at low risk for surgery. It is a relatively short procedure, often lasting under an hour, and usually results in a short recovery with most patients going home the next day. However, there are risks associated with the TAVR procedure, and the most serious include death, stroke, serious damage to the arteries, or serious bleeding.
Most importantly, TAVR can give people their lives — and quality of life — back. An overwhelming majority of heart valve failure patients who underwent the procedure were alive with improved health and quality of life years later.
Dr. Dearman’s story
Dr. Dearman has always been an active person. He attended college and medical school on an army scholarship, and served 16 years in the U.S. Army Reserve Medical Corps, where he rose to the rank of Lieutenant Colonel and received Meritorious Service Medals in 1985 and 1988.
“The army has very definite physical standards, and I had always been very physically active. I love running, jogging, and aerobic activity,” he said.
But as time passed, he noticed that he became short of breath more easily. “Like everyone, I thought, ‘Well, you’re older. What do you expect?’” he said. “I was putting on weight. And I thought, ‘Well, not only are you older, but you’re fat. What do you expect?’”
After his wife noticed his heart murmur, Dr. Dearman spoke with a fellow cardiologist and determined that the best option was a TAVR. His recovery was relatively fast — he went home the next day and was back at work in the operating room a week later. “When I woke up, I could tell immediately a difference in how I felt,” he said. “It was a dramatic change. The fact that I felt better meant I hadn’t waited until it was too late.”
Unsurprisingly, Dr. Dearman offers words of encouragement for people diagnosed with heart valve failure: “Put yourself in the hands of people you trust, think of your family, and think of what life is like now and what you have left to live for,” he said. “And realize that all that can be extended and improved. Don’t be afraid to face something that can be fixed.”
If you or someone you know has heart valve failure and is experiencing symptoms, don’t wait. Don’t let fixable become fatal. Speak to your doctor right away.
To learn more, visit www.TreatHeartValveFailure.com
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