A River Falls man will be able to enjoy fields of vegetables again thanks to a new tricuspid valve procedure
Jim Barron worked for 45 years in the seed production business. He walked five to 10 miles a day through the muddy fields where he and his wife grew the flowers and vegetables that they sold at the River Falls Farmers Market. He never got tired enough to need to recharge with a nap, so when he turned 70 and started feeling tired, he knew it was time to get his heart checked.
“I walked cornfields and inspected fields all summer long,” he said. “I ran cross country and track in college, so that's why I was wondering why this heart situation occurred because I felt that I had a pretty good heart.”
About three years ago, Jim had a stroke. He was out in the field when it happened. Luckily, his wife Deb and their business partner were out cutting flowers, so they were able to get Jim help quickly. He was given medication to break up the clot that caused the stroke. He was also referred to the M Health Fairview Heart Clinic - Maplewood for follow-up care.
Jim had a Watchman device implanted to close his left atrial appendage, a small pouch in the heart where blood can collect and form clots. The device helps prevent blood clots and reduces the risk of stroke for patients, like Jim, with Atrial fibrillation – or AFib. AFib is an irregular heartbeat that can cause blood to pool and dangerous clots to form.
When the team at M Health Fairview St. John’s Hospital was working with Jim for the Watchman, they noticed he had a leaky tricuspid heart valve. The tricuspid valve controls the flow of blood between the upper and lower chambers on the right side of the heart. If the tricuspid valve does not close properly when the heart beats, blood can flow backwards, causing backup of fluid.
Tricuspid valve leaking can lead to:
- Feeling weak or tired
- Shortness of breath
- Fast or pounding heartbeat
- Pounding or pulsing feeling in the neck
- Swelling in the legs, abdomen, or neck
- Decreased need to urinate
“My heart was starting to enlarge a bit,” Jim said. “It wasn’t major, but eventually we would have to do something, or it would continue to get worse.”
Previously, the only treatment would have been open-heart surgery. But in recent years new options for tricuspid valve treatment have been approved. Jim was among the first in our health system to get the new TriClip device during a minimally invasive procedure at M Health Fairview St. John’s Hospital.
“Jim's symptoms were subtle, but he had early signs of right heart failure,” said Marat Yanavitski, MD, an interventional and structural heart disease cardiologist with M Health Fairview. “If we can get to these patients early, we can change their whole course. He’s a pretty young guy, but I’d still hate to put him through an open-heart procedure. He did well and expressed how much better he felt.”
Jim said the procedure was easy from his perspective – just like when he had the Watchman. He stayed overnight and went home by noon the next day. He said he felt nearly no pain, just a little soreness at the incision site.
But from Yanavitski’s perspective, the procedure isn’t simple. After a thorough work up and multidisciplinary review, the heart team develops a plan to ensure the procedure is a success for each patient based on their specific anatomy.
With the patient asleep, the cardiologist makes a small incision in the leg and threads a catheter through a vein up to the heart. Once the device is in the right place, two clips are placed to bring the valve leaflets closer together. The leaflets are part of the valve that open and close, pulling them together decreases the amount of leaking that is present. The procedure can be done in one to two hours.
The patient is then taken to recovery for a few hours of bed rest. They stay overnight, so the team checks everything again in the morning. They usually go home in the afternoon.
The clip should last Jim for the rest of his life. Yanavitski said for someone like Jim, this catheter-based approach is helpful because it can prevent further damage to their heart without the risk of open-heart surgery.
“This builds on our team's experience in the burgeoning space of tricuspid disease,” Yanavitski said. “We were part of the TR Clasp II clinical trial, using a similar device and we became the first center in the region to offer catheter-based repairs for the tricuspid valve, which until recently did not have many treatment options.”
“I think my blood is circulating better now,” Jim said. “I can walk up the steps and I don't get winded.”
He said when the weather gets better, he looks forward to going pheasant hunting and walking through the paths and his five acres of vegetables and flowers again.
