Earlier this year, Flinders woman Kaye Breakspear found herself unable to breathe, and took herself to hospital thinking she had a bad case of COVID-19.
But when X-rays found her lungs full of fluid and a problem with her heart, she ended up facing risky open heart surgery to fix a life threatening condition called aortic stenosis.
"I was being prepped for open heart surgery, but they ended up classing me as a high risk patient, because of radiation therapy and chemo I had years ago, and they said it wouldn't be a good outcome for me," she said. "It was a pretty horrific time."
Enter Wollongong cardiologist Dr Ed Danson, who told Ms Breakspear about TAVI - or transcatheter aortic valve implantation.
For eligible patients with aortic stenosis, where the valve between the heart and the aorta is narrowed and doesn't fully open, TAVI replaces the need for surgery with a minimally invasive procedure.
"Aortic stenosis can be a fatal condition - Kaye has such a severe case that she wouldn't have been expected to survive more than a year," Dr Danson said.
"Conventional management is open heart surgery, where the patient has to be put under general anaesthetic, sawed open, put on a machine and the heart has to be stopped and cut open. The valve is then surgically sewed in."
He said the recovery time for this was at best about a month, and for many patients - especially those with other conditions, like Ms Breakspear - could be months or even years.
"Some people never feel quite the same, because it's quite an invasive thing to do to someone," he said.
In contrast, TAVI is done with the patient awake and usually requires no more than a day or two in hospital.
"Patients are slightly sedated, but basically awake, liberal amounts of local anaesthesia to both groins where doctors can access the femoral artery," he said.
"The valve is made of a springy material, which collapses down to the size of a catheter the diameter of a thick pen."
Using a catheter up through the femoral artery, the new valve is positioned in place of the blocked valve.
"Most people, even those who have got a disease as severe as Kaye, feel better straightaway and there is no recovery time, in fact you would only really stay in hospital for a night or two," Dr Danson said.
Dr Danson has previously had to take his patients to Sydney to perform this procedure, but for the first time in July it was able to be performed in Wollongong under his guidance working with a team at the newly expanded Cardiac Centre.
He says this has huge benefits for Illawarra patients, as they no longer have to travel or rely on out-of-town teams to coordinate their care.
"There is a lot of preparation work that goes into this - we have to consult surgeons and weigh up the risks, basically no decisions are made on the day," he said.
"So if you depend on another team, there is loss of communication and you might have to make dozens of trips up to Sydney to have all the scans done.
"You also run the risk that if things don't go to plan afterwards, you could end up in your local emergency department and no one knew anything about what was happening."
"We know the more fragmented someone's care is, the worse the outcomes are - it's not just inconvenience from travelling - because it means information is lost."
"Having one place where everything is done means there is no loss of information - there is a surgeon literally across the hall from my office who I can consult with."
Ms Breakspear was the second patient to have the TAVI inserted in Wollongong and says it was instantly life-changing.
"I don't know if I would have survived open heart surgery, and I'm amazed that I could have something done that's fixed it just like that," she said.
"I feel fabulous, before I was breathless and had angina pain and now I've got absolutely nothing."
For the founder of the Cardiac Centre, Dr Astin Lee, having the TAVI procedure become available locally is part of the reason he wanted to expand his heart health service.
"We wanted to accommodate an expansion of services, and new services and the skills of our doctors," he said.
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