UHealth Transcatheter Aortic Valve Replacement (TAVR) Program Sets Milestone With Same-Day Patient Discharge

Transcather aortic valve replacement patient Esther Pineda (center) with Dr. Nikolaos Spilias (right) and Doris Rodriguez.
Transcatheter aortic valve replacement patient Esther Pineda (center) with Dr. Nikolaos Spilias (right) and daughter Doris Rodriguez.
Article Summary
  • Esther Pineda was the first South Florida transcatheter aortic valve replacement patient to be discharged the day of her surgery.
  • Dr. Nikolaos Spilias, Pineda’s physician, said the quick release from the hospital is important because patients with short hospital stays do better.
  • Prior to the procedure, Pineda tired easily, but her stamina has improved and she feels more energetic since her release from the hospital.

When Esther Pineda was diagnosed with severe aortic stenosis, a serious condition where the aortic valve does not open well, she turned to the leading-edge interventional cardiology team at UHealth — University of Miami Health System for a valve replacement.

“I was a little nervous, because I never needed surgery before in my life,” said the 89-year-old, Cuban-born Orlando resident. “My brother-in-law had to spend a week in the hospital years earlier after open heart surgery.”

But Pineda was able to go home only a few hours after her minimally invasive transcatheter aortic valve replacement (TAVR) procedure last January, the first such same-day discharge in South Florida.

“Our experience with the TAVR procedure has grown exponentially during the last two decades, with significant improvements in its technique and outcomes,” said Nikolaos Spilias, M.D., assistant professor of cardiovascular medicine at the University of Miami Miller School of Medicine. “We know that minimizing a hospital stay after a procedure is better for patients and their families.”

“This milestone exemplifies how our advanced TAVR program results in top clinical outcomes,” said Yiannis Chatzizisis, M.D., Ph.D., professor and chief of cardiovascular medicine at the Miller School. “Our goal is to eventually have 20 to 40 percent of our TAVR patients discharged to go home the same day after their procedure.”

UHealth provides a single destination for comprehensive evaluation and treatment of any heart valve condition, said Pedro Cox-Alomar, M.D., associate professor of cardiovascular medicine and medical director of the UHealth Structural Heart and Valve Program.

“Our multidisciplinary team approach is laser-focused on delivering personalized, patient-centered care through shared decision making,” he said. “We understand that different perspectives promote excellent outcomes in complex cases.”

Dr. Nikolaos Spilias performing surgery in the Catheter Lab.
Dr. Nikolaos Spilias in the UHealth Catheter Lab.

Prior to her heart valve replacement, Pineda felt rundown and out of breath when working as a seamstress for her industrial clients.

“I really couldn’t do much of anything because I was getting tired very easily,” she said.

On the day of her procedure, Pineda arrived at UHealth Tower in the morning with her daughter, Doris Rodriguez. Dr. Spilias led the team that replaced her aortic valve through a catheter inserted in her groin.

“I was under ‘twilight’ sedation and local anesthesia and could talk to the doctor,” Pineda said. “There was no pain at any time.”

After being monitored for about six hours, Pineda was able to leave the hospital that evening.

“Esther was able to walk without any issues, her vital signs were normal and an echocardiogram showed the new valve was working great,” said Dr. Spilias. “She had a strong support system at home, which is one of the key criteria for same-day discharge.”

Pineda says she trusted Dr. Spilias because of his kindness and thorough attention.

“He’s an angel from heaven,” she said. “He called my daughter every day, and always made sure I had everything I needed.”

In fact, everyone on the cardiology team treated Pineda as if she were their own mother, added Rodriguez.

When Pineda and Rodriguez returned to Dr. Spilias in February for a one-month follow-up, all tests showed that the new aortic valve was functioning great. Now, Pineda is once again altering clothes for her clients without limitations.

“I can spend the whole day sewing and not feel tired,” she said. “My friends and acquaintances say I look more animated and stronger and, every day, I feel a little better. I was in good hands and I am thankful for Dr. Spilias every day.”

“At the University of Miami, we implement the most cutting-edge and modern techniques during TAVR and other valve procedures, that are key for a successful procedure and quick recovery,” Dr. Spilias said. “When appropriate safety criteria are met, the patients can be discharged on the same day after valve replacement, something that was considered to be impossible a few years back. We are very happy to see the patients getting back home with their families and loved ones quickly and start living a new life.”

Tags: aortic valve replacement, Division of Cardiovascular Medicine, Dr. Nikolaos Spilias, Dr. Pedro Cox-Alomar, Dr. Yiannis Chatzizisis, heart care, heart disease, TAVR