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Neysa’s Story: Keeping the Beat

Neysea's Story In ContentA minimally invasive procedure gives patients suffering from severe aortic stenosis a second chance.

Neysa Smith was near death when she saw Premier Health cardiologist C. David Joffe, MD, and learned of a procedure that could save her life.

“She was in heart failure, she was delirious,” said Lori Huddleson, Neysa’s niece. “It was dire.”

Neysa said the symptoms she experienced were terrible. She could barely breathe. “I couldn’t walk; I couldn’t talk much; I couldn’t take care of myself,” she said. “I couldn’t balance my checkbook. I couldn’t do my pills. I couldn’t work my phone. By the time I saw Dr. Joffe, I was a mess.”

Lori, who works as a nurse, said that Neysa’s Premier Health pulmonologist believed her heart was the cause of her health concerns, and he suggested that she see Dr. Joffe.

“In Neysa’s particular case, she was literally dying from severe aortic stenosis – meaning the valve was too narrowed; the heart had to work too hard; her heart was failing,” Dr. Joffe said. “And if she didn’t get a valve, she was going to die relatively soon.”

Dr. Joffe, an interventional cardiologist, is a member of a Premier Health team that evaluates patients for a minimally invasive transcatheter aortic valve replacement, or TAVR, procedure. He described the procedure as “putting in a heart valve without operating.”

With TAVR, the old heart valve is not removed or replaced, but instead acts like an anchor for the new heart valve. The new valve is guided into place through small incisions using a long thin tube (catheter), X-rays, and ultrasound.

“This is done for folks who either are too sick to have surgery or who have too high a risk for surgery,” Dr. Joffe said.

A Life-Saving Alternative

Premier Health physicians in 2014 became first in the Dayton region to successfully replace an aortic valve in a beating heart.

“We try to stay on the forefront of cardiovascular treatment, and particularly with the treatment of patients without surgery if possible,” said Dr. Joffe, who performed Neysa’s TAVR procedure.

Aortic stenosis is a fairly common heart condition in the United States, especially among older patients. “It’s usually a degenerative condition – meaning with aging – as it’s part of the atherosclerotic, or hardening of the artery, process,” Dr. Joffe explained.

Patients approved for TAVR do not have to undergo traditional open-heart surgery to replace the valve, meaning they will experience a much shorter, less difficult recovery, among other benefits.

“Rather than having the chest opened and the heart stopped using heart-lung bypass, the heart continues to beat during the procedure,” Dr. Joffe said.

The TAVR procedure is performed at Miami Valley Hospital, but the multidisciplinary TAVR team is composed of specialists from across Premier Health. The program also has a certified nurse specialist who assists with pre-operative testing, post-operative care and patient follow-up after the procedure.

“In the case of TAVR, it’s most often a group decision,” Dr. Joffe explained. “Sometimes we’ll say, ‘This one’s better for surgery’ or ‘This one’s not quite ready’ or ‘This one needs more workup,’ and then we proceed accordingly.”

Neysa believes TAVR is a great option, especially for patients like her who are, for any number of reasons, unable to have traditional open-heart surgery.

“If I wouldn’t have had that, I wouldn’t be here,” she said. “I just thank God for Dr. Joffe and his team. They were very instrumental in keeping me alive.”

Dr. Joffe said that offering the TAVR procedure is an important benefit to the community.

“Patients don’t need open heart surgery; they don’t need their chest opened; they don’t need their aorta opened,” he said. “And literally as soon as the valve is in place, assuming the heart has enough stamina left, within a matter of seconds, the condition is alleviated and the patient can begin to recover.”

Reclaiming Quality of Life

TAVR not only allowed Neysa to live, but to become the woman she used to be, Dr. Joffe proclaimed.

“We were able to undertake the appropriate workup and get her ready and place a valve, and over a year later, she’s a totally different woman,” he said. “She was frail, weak, looked 20 years older than she is, couldn’t walk across the room – and she’s independent now.”

Lori, Neysa’s niece, said Neysa’s recovery was more difficult than typical for TAVR patients because she became so debilitated before the procedure. Still, Neysa said she’s “doing anything and everything” now.

“It was kind of slow, but it went OK,” Neysa said of her recovery. “I had a lot of rehab and stuff like that, and a lot of help from Fidelity Health Care until my strength built up.”

Though she needed rehabilitation to increase her stamina, Neysa described as almost immediate the relief she felt of symptoms affecting her quality of life prior to the procedure. “I could breathe, and I could think,” she said. “My niece comes and does my medicine box every week. But other than that, I’m doing great.”

Lori agreed. “I would say her quality of life is back to the way it was before,” she said. “She’s able to do all her activities of daily living as she did before.”

While survival rates after the procedure vary based on the overall condition of the patient’s heart, their age, and other factors, Dr. Joffe said that Neysa, who is still in her early 60s, “should be able to now enjoy a number of years to come.”

The TAVR procedure also is greatly beneficial for older patients, said Dr. Joffe.

Before TAVR, a diagnosis of severe aortic stenosis for patients unable to undergo surgery was basically a death sentence.

“It’s very gratifying to see patients in their late 80s or early 90s, whom we’ve treated, who say they feel like they’re 20 years younger,” Dr. Joffe said. “Because this can be a gradual process, they don’t realize how tired and weak they are; they just attributed it to aging.”

Don't Give Your Heart to Just Anyone. Trust Premier Health.

Improving the quality of your life is at the heart of what we do. Premier Health is proud to provide a wide spectrum of heart and vascular services across Southwest Ohio. We offer compassionate, award-winning care designed for positive patient outcomes – with fewer complications, shorter recoveries, and long-lasting benefits. We welcome patients seeking second opinions about their heart and vascular treatment options.

If you or a loved one would like more information about Premier Health’s cardiovascular programs, please call (937) 499-7427(937) 499-7427.

Content Updated: October 23, 2018

These Miami Valley Hospital locations offer Cardiology Services.
Cardiology and Vascular Services at Miami Valley Hospital
One Wyoming St. Dayton, OH  45409
Outpatient Cardiac Testing - Beavercreek
2619 Commons Blvd. Suite 102 Beavercreek, OH  45431
Outpatient Cardiac Testing and Rehabilitation at Medical Imaging – Beavercreek
1244 Meadow Bridge Dr. Beavercreek, OH  45434
Outpatient Cardiac Testing and Rehabilitation at Medical Imaging - Jamestown
4940 Cottonville Rd. Jamestown, OH  45335
Outpatient Cardiac Testing and Rehabilitation at Miami Valley Hospital
One Wyoming St. Dayton, OH  45409
Outpatient Cardiac Testing and Rehabilitation at Miami Valley Hospital - Cardiovascular Services
122 Wyoming St. Dayton, OH  45409
Outpatient Cardiac Testing and Rehabilitation at Miami Valley Hospital South
2400 Miami Valley Dr. Centerville, OH  45459
Outpatient Cardiac Testing and rehabilitation services at Miami Valley Hospital North
9000 N. Main St. Englewood, OH  45415
Outpatient Cardiac Testing at Miami Valley Health Center - Huber Heights
6251 Miami Valley Way Huber Heights, OH  45424
Outpatient Cardiac Testing at Miami Valley Health Center Greenville
742 Sweitzer St. Greenville, OH  45331
Premier HeartWorks at Miami Valley Hospital South
2400 Miami Valley Dr. Centerville, OH  45459
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