Making History: Sentara sees success in innovative heart valve procedure for high-risk patients

If Jim Gibson had to guess, he has collected more than 400 Native American artifacts on the 340 acres of his soybean farm in Emporia, Va.

“I would walk miles up and down the fields, whenever I got the chance, looking down for arrowheads or old tools,” said Jim, now 81, whose main residence is in Chesapeake, Va.

Jim’s face lights up when he talks about his farm and the years he’s spent exploring his land. Over the last year, Jim has no longer been able to go on his long walks or spend his days turkey hunting, some of his favorite hobbies. In December, he was diagnosed with severe aortic valve regurgitation that led to congestive heart failure and hospitalization.

“I was at the point where life wasn't even fun,” Jim said. “I couldn't do the things I liked to do. I was ready to give up.”

Fatigue, occasional blackouts, and severe swelling in his legs greatly impacted his quality of life.

Jim’s granddaughter, Emmy Bevins, RN, is a cardiac care recovery nurse at Sentara Norfolk General Hospital and takes care of heart valve patients after their surgeries. She watched as her grandfather’s health continued to decline, and knew she had to do something to save him.

She took her concerns to Matthew Summers, M.D., an interventional cardiologist, director of Sentara’s Structural Heart program, and co-director of the Sentara Heart Valve Center.

Unbeknown to Emmy, Dr. Summers happened to be one of the few people in the country, along with his co-director of the Sentara Heart Valve Center, cardiothoracic surgeon Clinton Kemp, M.D., who are investigating a new procedure that could save her grandfather’s life.

Sentara’s continued quest to improve heart failure treatment

Until the last decade, the only treatment for aortic stenosis was open-heart surgery. Patients who were in such poor health that they could not tolerate a major operation generally were out of options; they simply got sicker.

The transcatheter aortic valve replacement (TAVR) procedure changed that for many patients, providing an alternative that allows interventional cardiologists and surgeons to repair dysfunctional heart valves through a minimally-invasive procedure using the patient’s femoral artery. The Sentara Structural Heart program has led the nation in TAVR research over the last 15 years.

Still, many high-risk heart failure patients remained out of luck. Those with aortic regurgitation often do not have enough calcium at their valve to anchor the TAVR device in place, leaving open-heart surgery as the only option in most cases.

Today, Sentara Health is helping to change that as part of an ongoing effort to fill significant treatment gaps for patients with different types of heart disorders.

Dr. Summers and Dr. Kemp are using a new investigational device called the Trilogy transcatheter heart valve (THV) to expand the pool of TAVR patients to include those with aortic regurgitation. The Trilogy transcatheter heart valve can stay in place in the patient’s heart without relying on calcium buildup, a breakthrough for high-risk patients with aortic regurgitation.

Dr. Clinton Kemp, Sentara cardiothoracic surgeon (L) and Dr. Matthew Summers, Sentara interventional cardiologist (R).

Sentara Norfolk General Hospital is one of 30 sites across the country currently performing this procedure, a group that also includes hospitals in Washington D.C, Baltimore, Md., and Charleston, S.C.

Hospitals are performing this procedure as part of the national ALIGN-AR clinical trial. The Sentara Health Research Center participates in more than 150 active clinical trials to advance patient safety and effective treatments.

“We’re developing options for as many patients as we can, so no one is left behind,” Dr. Summers said. “The Trilogy Heart Valve system is a novel device that fills a treatment gap that we have had nationally for many years. We don’t want people to have to travel far to get life-saving care, and we are proud to be one of the few centers capable of offering this valve therapy.”

“It’s proving to be a fantastic option for what has really been an orphaned disease,” Dr. Kemp said. “These patients don’t have the anatomy for conventional TAVR procedures and are just too ill, frail or elderly for open surgery, but now they have early access to what I believe will be a very groundbreaking device.”

A new lease on life

On February 28, Jim Gibson became the fourth patient in Virginia and one of just 358 patients in the United States to receive the Trilogy Heart Valve system. 

Jim Gibson pictured with Dr. Summers, right before his procedure at Sentara Norfolk General Hospital.

Emmy was one of the first faces Jim saw when he woke up from his hour-long procedure.

“Hey Poppy! Remember me!” Emmy recalled saying. She scheduled a shift in the cardiac recovery unit the day of his surgery to make sure she was one of his caretakers.

Later that day, Jim was walking the hallways with his care team. He remembers making two or three laps around the unit, something his body wouldn’t have allowed less than 24 hours before.

“I was a candidate for the morgue before I got the valve,” Jim said. “But Dr. Summers told me there was hope with this new procedure. I'm still learning more and more about how lucky I am to be able to get the valve and that we have the expertise to be able to install it.”

Pictured from left to right: Dr. Clinton Kemp, Jim Gibson, Emmy Bevins, Dr. Matthew Summers.

“Mr. Gibson is doing so well that he went turkey hunting two weeks after his valve replacement, climbing up and down a tree stand,” Dr. Summers said. “We are proud of his recovery efforts and ecstatic with our entire team’s approach to patients like him that allows application of new medical technology to solve previously unsolvable problems.”

Before the surgery, Jim was thinking of his future in terms of days and weeks.

Recently, he took his bicycle out of the garage to get it ready to take to his farm once he gets cleared for more cardio activity.

He’s most excited for his first Turkey hunt in the fall, which is months away.

“I’ve got a new lease on life,” Jim said. “It changed my way of thinking. I wasn't thinking about living for another year. Now I'm thinking for the next five years.”

Jim Gibson’s first turkey hunt 13 days after his heart valve replacement surgery (L), Jim Gibson riding his bike, the first time in years, on Memorial Day.