January 25, 2021
Typically, we photograph every patient appearing in HealthU. Because this story was planned during the surge of COVID-19, that contact would have been too risky. Instead, our team took a creative approach and replaced photo shoots with illustrated portraits of patients.
Rosa Martinez is used to working hard. At age 73, the mother of five from Perth Amboy, New Jersey, was on her feet a good chunk of the week, working part-time at a warehouse job. The physical demands of her job never bothered her, so when she started getting short of breath and feeling unusually tired, she knew something was wrong. It wasn’t just “getting old.”
She saw her primary care doctor, who ordered a number of tests and diagnosed her with aortic stenosis—the narrowing of the valve that allows blood to flow to the aorta, which in turn blocks blood flow and causes the heart to work harder.
The diagnosis came as quite a surprise to Rosa and her family. “She never had any health problems before that,” says her daughter, Maryluz Martinez, adding that there was no family history of heart valve disease.
It is not unusual for patients diagnosed with aortic stenosis, or aortic valve stenosis, to have no family history of heart valve disease, says Saleem Husain, M.D., Rosa’s primary cardiologist and catheterization lab and chest pain medical director at JFK University Medical Center, because heart valve disease is largely a degenerative disease related to aging.
Until about a decade ago, the only treatment for aortic valve stenosis was open heart surgery, says Tilak Pasala, M.D., an interventional cardiologist who was part of Rosa’s cardiac care team. While open heart surgery might be the best option for some patients, it is more complicated and has a longer recovery.
But a minimally invasive procedure has revolutionized heart valve replacement. “Transcatheter aortic valve replacement, or TAVR, has changed the landscape,” Dr. Pasala says. “By 2025, it is predicted that 75 percent of those particular valve surgeries will be done this way.”
New Approach to Coordinated Care and Advanced Options
Advanced cardiac procedures such as TAVR are performed at hospitals with comprehensive cardiac programs to treat the most complex heart conditions. Experts from Hackensack University Medical Center and Jersey Shore University Medical Center now see patients at JFK for comprehensive evaluation and treatment planning, all in coordination with their local physicians.
This new cardiac specialty clinic provides easy access to the most advanced medical and surgical procedures in the state, including:
- Cardiac surgery
- Complex cardiac intervention
- Structural heart procedures
- Advanced heart failure treatment
- Electrophysiology procedures
Innovative Solutions for Complex Heart Problems
Dr. Pasala is one of several cardiac experts who are part of this well-coordinated initiative. He met with Rosa and Maryluz to explain the surgical options, which conveniently took place at JFK. Because Rosa speaks only Spanish, Maryluz and JFK’s translator were there to make sure all the complicated medical terminology was understood. But Dr. Pasala did his best to use the little Spanish he knew to connect directly with Rosa.
Rosa appreciated the effort. “He was able to tell her in Spanish what was happening,” Maryluz says. “She feels better when she can communicate [in her own language].”
Dr. Pasala and a multidisciplinary team of cardiologists, surgeons, structural heart specialists and intensivists discuss all cases to determine the best treatment strategy available for each patient for a heart team approach to care.
Dr. Pasala and the heart team recommended the TAVR procedure for Rosa as an appropriate treatment rather than open heart surgery. The family was relieved that the TAVR procedure was an option. “It was a lot better because my mom was scared,” Maryluz says. “Open heart surgery can be a risky procedure.”
The TAVR procedure is done by way of catheters, most often inserted through an artery in the groin or occasionally through a 4-inch incision between the ribs. Benefits include:
- No need to open the chest
- No general anesthesia
- No stopping the heart
- Short recovery (usually home within one to two days)
- Little to no pain
“Through the new Cardiac Specialty Clinic at JFK, cardiac specialists provide consultations and diagnostic procedures close to home for patients like Rosa who live in the Edison area. The cardiac specialists then perform the necessary heart surgeries and minimally invasive procedures at Hackensack and Jersey Shore,” says George Batsides, M.D., chief of cardiac surgery at Hackensack, who performed Rosa’s TAVR procedure along with Dr. Pasala.
“Our goal with the heart clinic at JFK is to make it easier for patients from Edison and the surrounding area to be able to get high-level care at the hospital they’ve trusted for years,” Dr. Batsides adds.
Patients like Rosa receive all the diagnostic tests, consultations with the medical team and follow-up care close to home at JFK, while the complex heart procedures such as TAVR take place in Hackensack or Neptune.
At JFK, to diagnose Rosa’s heart problem, she benefited from the cardiac catheterization services, which now include a new state-of-the-art Cardiac Catheterization Lab that opened in summer 2020. With the most advanced technologies available for cardiac catheterization care, the lab is expected to treat about 3,500 patients a year, primarily with diagnostic catheterizations to identify heart conditions and angioplasty to resolve heart artery blockages or narrowing.
Living Her Best Life
Rosa’s care was seamlessly coordinated when she came to Hackensack on the day of the procedure. The procedure was performed in the morning at the newly built, specialized hybrid operating room at the hospital. Rosa responded so well to the TAVR procedure that she was able to go home the same day. She even walked out of the hospital on her own rather than having to be taken by wheelchair to the hospital entrance.
“They treated her very well,” Maryluz says. Before the procedure, which took place during the COVID-19 pandemic, a member of the care team explained to her all the safety measures that the hospital had in place, and on the day of the procedure before getting started, her surgical team explained the procedure and how things would unfold. She had a private room for recovery after the procedure was complete.
“She says the hospital and the doctors made her feel very safe and involved,” Maryluz says.
Best of all, Rosa is feeling good again. She’s back to running the household, caring for her grandchildren and walking her dog. One thing she isn’t doing, though, is going back to work. She has decided to retire, her daughter says, but not because of her health. “She’s just trying to live her best life now,” Maryluz says.
Next Steps & Resources:
- Learn more about heart care at Hackensack Meridian Health
- Meet out sources: George Batsides, M.D., Tilak Pasala, M.D. and Saleem Husain, M.D. To make an appointment with Dr. Batsides, Dr. Pasala, Dr. Husain or another doctor near you, call 800-822-8905 or visit our website.
- What does a cardiac stress test reveal?
- Top advice for heart health
The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.