Three years after TAVR, a local farmer is still going strong

physician's brief image for tavar

A minimally invasive heart procedure for Gilbert Corss, 84, improved his quality of life — and possibly saved it.

At 84 years old, Gilbert Corss isn’t interested in slowing down. And a transcatheter aortic valve replacement (TAVR) procedure in 2013 is helping him stay active.

A farmer in the small town of Vandalia, Michigan, Corss had warning signs of declining health. But his commitment to caring for his wife, who had dementia, kept him from seeing a doctor, as did his work in the fields growing soybeans and raising hogs and prize chickens.

Shortness of breath led to diagnosis

After his wife died in 2012, Corss could no longer ignore his health issues, which included shortness of breath and poor circulation.

A veteran of the Korean War, Corss visited the Veterans Affairs hospital in nearby Battle Creek, where he was diagnosed with aortic stenosis. The doctors there referred him to the University of Michigan Frankel Cardiovascular Center for the specialized care he needed. U-M cardiologist P. Michael Grossman, M.D., determined that Corss would be a good candidate for a minimally invasive TAVR procedure because of his age and health issues.

U-M has performed more than 800 TAVR procedures, the most of any health system in the state, and is one of the top programs in the country in terms of TAVR volume.

Benefits of a TAVR

Patients who undergo a TAVR procedure experience less downtime, faster recovery and, often, a shorter hospital stay (three to five days on average) than patients undergoing open-heart surgery. Most begin gaining back their strength and start cardiac rehabilitation within days or weeks, resulting in dramatic improvements in quality of life.

Corss’ TAVR kept him hospitalized over Christmas 2012, a small price to pay for a much-improved quality of life, says his daughter, Connie. When a freak accident left Corss pinned under his tractor several months later, she says she thinks her father’s improved health after his TAVR procedure played a part in helping him survive.

Still farming after all these years

physician's brief image for tavar article

While his farming days aren’t what they used to be, Corss still gets out to work on his tractor, tend to his chickens and do odd jobs around the farm, where he’s lived for 56 years. 

He’s able to live alone and continues to drive, making regular trips to Walmart, Kroger, Taco Bell and McDonald’s. “He makes a morning of it,” Connie says. “He gets up early to beat the crowds.”

“I think the world of my TAVR team,” says Corss, thanking Grossman, Stanley Chetcuti, M.D., and Himanshu Patel, M.D., for his renewed energy and strength.

Valve Disease

EXPANDING THE POSSIBILITIES IN OPTIMAL VALVE INTERVENTIONS

Aortic Valve Disease 

Aortic Valve Distribution
  2011 2012 2013 2014 2015
Replacement 270 323 381 345 345
TAVR 27 99 127 164 200
AV Repair or Resuspension 65 47 51 43 44
Valve Sparing 25 31 36 32 19

Open Approach
Historically, open surgical aortic valve repair (SAVR) has been the standard treatment for severe aortic stenosis. For more than 25 years, the Frankel CVC has been a leader in aortic valve replacement in both volume and outcomes.

The Frankel CVC is one of only a few sites in the nation to conduct the TRANSFORM clinical trial for the INTUITY valve system developed by Edwards Lifesciences. This trial offers a potentially significant advancement in valve replacement surgery because it allows the surgeon to implant the valve with only three sutures, substantially decreasing the time required for the surgical intervention.

Transcatheter Approach
Transcatheter aortic valve replacement (TAVR) is a minimally invasive, catheter-based procedure to replace the aortic valve in patients with severe aortic stenosis. It is an alternative to SAVR. Originally developed for intermediate- and high-risk patients who were not candidates for an open heart procedure, TAVR is now available to low-risk patients.

The University of Michigan Health System (UMHS) is one of the only health systems in the region to offer the full spectrum of valve options available through clinical trials as well as FDA approved devices. U-M is also one of only two health systems in Michigan invited to participate in a clinical trial offering TAVR for low-risk patients.

Our interventional cardiologists and cardiac surgeons work together to seamlessly deliver these TAVR devices through a variety of access points, including: femoral, transapical, direct aortic or subclavian arteries.

TAVR technology is also being used to restore the function of failing bioprosthetic valves and may be the best valve replacement option for high-risk patients. The procedure is often referred to as “valve-in-valve.”

The U-M team is also breaking new ground in the treatment of bicuspid aortic valve (BAV) disease. Our surgeons are some of the most experienced in the world in treating patients with BAV disease. U-M has established a Bicuspid Aortic Valve registry to study patients and identify the genetic causes and long-term effects of this common congenital disease.

Our multidisciplinary approach enables us to offer additional surgical and transcatheter options for patients with complex aortic valve conditions, including:

  • Valve-sparing operations on the aortic root
  • Treatment of paravalvular leaks
  • Placement of stentless aortic valves
  • Hypothermic circulatory arrest procedures

Aortic Valve Distribution

800 tavrs and counting

Mitral Valve Disease 

Open Approach
The Mitral Valve Clinic at the Frankel CVC is one of the largest practices in the country focused on mitral valve repair. Our team’s extensive experience in the operating room is a direct result of high procedure volume, which translates into better outcomes for patients.

Mitral valve repair is one of the few cardiac procedures where a patient’s life horizon returns to what it would have been naturally without a mitral valve condition. Performing these repairs in patients before their mitral valve disease progresses into life threatening heart conditions such as atrial fibrillation, embolism, blood clots, stroke and congestive heart failure is our top priority.

We also offer surgical valve replacement when that is the patient’s best option. Each member of the Mitral Valve Clinic team has extensive experience in diagnosing, monitoring and treating mitral valve disease, including mitral regurgitation, mitral stenosis and mitral valve prolapse (Barlow’s syndrome).

Our Mitral Valve Clinic is also a leader in the treatment of mitral regurgitation associated with heart failure from both dilated and ischemic cardiomyopathies. Transcatheter Approach Our cardiac surgeons and interventional cardiologists work together to offer eligible patients minimally invasive and endovascular options for mitral valve repair and replacement, including:

  • Commercially available MitraClip® device indicated for  high-risk patients with degenerative mitral regurgitation
  • Participating in Abbott’s CoAPT trial, treating functional  mitral regurgitation with the MitraClip®

Tricuspid Valve Disease
Treatment for tricuspid valve disease varies depending on a patient’s condition. As symptoms progress, treatment may include certain medications such as diuretics, which promote urination and the release of excess fluids, and vasodilators, which help open blood vessels. If a patient’s condition is severe, surgery to repair or replace the damaged valve may be required.

Types of tricuspid valve disease include:

  • Tricuspid regurgitation
  • Tricuspid stenosis
  • Tricuspid atresia
  • Ebstein’s anomaly

CLINICAL TRIALS

CoAPT

The purpose of this study is to assess the clinical outcomes of the MitraClip® Percutaneous Therapy for extremely high-surgical-risk patients.

Edwards Lifesciences PARTNER II

The purpose of this study is to evaluate the Sapien 3 valve (Edwards’ 3rd generation TAVR and 2nd generation XT valve).

REPRISE III

This is the pivotal IDE trial of Boston Scientific’s Lotus™  Valve System.

Medtronic Valiant EVO
The purpose of this study is to investigate the safety and effectiveness of the Valient Evo Thoracic Stent Graft System in subjects with a descending thoracic aortic aneurysm who are candidates for endovascular repair.

Terumo Thoraflex Hybrid

The purpose of this study is to determine if the Thoraflex Hybrid device is safe and effective in the treatment of aneurysm and dissection. In order to determine if Thoraflex Hybrid is safe to use we will collect information on patients that have the device implanted as part of the study.

For more information on these and other cardiovascular trials available at U-M,  visit www.umcvc.org/researchstudies.