First time procedure performed in downstate Illinois

PEORIA —Nick Craven received the news earlier this year that the valve placed in his heart a decade ago was beginning to leak and would need to be replaced.

Nick, who was 2 days old when doctors discovered his pulmonary valve was completely closed. At age 22, he had that valve replaced in what could have been expected to be his first of multiple open heart surgeries over his lifetime.

"It was four or five months of pain. I couldn't cough, couldn't sneeze, couldn't laugh. Really couldn't do much," Nick said.

The hours-long surgery, during which his heart was stopped while a machine pumped his blood, left Nick with a significant incision, cracked ribs and chest tubes that caused pain for months after the operation.

But in the 10 years that cow's valve was working to move blood through Nick's body, doctors were finding new ways to treat congenital heart patients like him. The FDA approved a new procedure only a month before Nick learned the valve would need to be replaced.

This time, doctors told him, they could deliver a new valve through a catheter fed through a vein in his leg. Dr. Priti Patel, a pediatric interventional cardiologist in the Congenital Heart Center at Children’s Hospital of Illinois who has extensive experience with congenital heart patients and trans-catheter valve replacement, would be trained on the new technique and perform the operation six months later, the first time such a procedure has been performed in downstate Illinois.

No open heart surgery. No cuts. Not even a stitch.

"We have three girls under the age of six, so this was a big relief," Nick's wife, Katrina, said. The family lives in Lake Camelot.

A trans-catheter, valve-in-valve replacement in general is no new development, and has been performed by doctors in Europe for 16 years, Patel explained.

But usually those are aortic valves, which follows a relatively simple route up the femoral artery then around the aortic arch and down to the aorta.

But a pulmonary valve is accessed through the other side of the heart. The catheter is threaded up the femoral artery, then back down through the right atrium then back up and around again.

In fact a significant amount of the five-hour surgery was spent threading the delivery mechanism through the final two centimeters to reach Nick's pulmonary valve.

"It's kind of like two loops that you have to make to get it, which makes it more challenging," Patel said. 

Nick said he could tell a difference immediately after surgery. His fingers and toes were a normal pink color, not purple or blue like they were when his circulation was poor.

He was up and walking hours after his surgery was complete on a Tuesday earlier this month and discharged from the hospital two days later. By Friday he was back in the office catching up on emails.

"They were like, 'You were in seven-hour surgery three days ago and you're walking in here doing emails.' I think everybody was thinking, 'What are you doing?'" Katrina said.

A generation ago, children born with congenital heart disease often didn't survive to adulthood, but because of advancements in pediatric cardiology over the last 20 to 30 years, patients like Nick are driving demand for adult congenital care, creating a new sub-specialty that few doctors are well versed in, but thanks to the work of doctors at the Children's Hospital of Illinois, the only comprehensive congenital heart center in Illinois outside of Chicago, he was able to get the cutting-edge care he needed close to home.

"Thank God we just got to stay here in Peoria," Katrina said.

 

Laura Nightengale is the Journal Star health and lifestyle reporter. She can be reached at 686-3181 and lnightengale@pjstar.com. Follow her on Twitter @lauranight.