First TAVR Procedure at Silver Cross Culmination of Months of Teamwork

For most of his life, Bob Guler said things were pretty uneventful healthwise – until he hit 65. 

“Then, everything started going downhill,” said the retired Frankfort accountant somewhat tongue-in-cheek. 

An irregular heartbeat led to an ablation and, ultimately, a pacemaker/defibrillator. Oh, and arthritis bad enough he had to have both hips replaced. 

Guler was able to go to the gym and ride the exercise bike and pedal the elliptical, but that ended during COVID-19 restrictions last year. Toward the end of the year, he started feeling listless and noticed he was having more trouble when climbing stairs. 

His primary care physician, Corinne Nawrocki, D.O., who is on staff at Silver Cross Hospital in New Lenox, and Heart Care Centers of Illinois Cardiologist, Joseph Stella, D.O., noticed as well. On an echocardiogram done earlier this year, Dr. Stella discovered Guler had severe aortic stenosis and referred him to the Multi-Disciplinary Heart Valve Team at Silver Cross.  

“Severe aortic stenosis is a life-threatening condition and he needed prompt evaluation,” said Dr. Stella, chief of cardiology at Silver Cross. 

After further testing, the Silver Cross Heart Valve Team told Guler he was a candidate for transcatheter aortic valve replacement (TAVR), an alternative to open heart surgery. 

“They go in through the groin instead of opening up your heart,” Guler said. “That sounded pretty good.” 

Interventional Cardiologist Ravi Ramana, D.O., medical director of Silver Cross’ structural heart program, said TAVR is done by inserting a catheter about the size of a pen through an artery in the leg and up into the heart. 

“A new tissue heart valve is then implanted inside the narrowed valve, resulting in a normal functioning valve,” said Dr. Ramana, who has performed over 500 TAVR procedures in the past nine years at a suburban Chicago hospital.

According to team Interventional Cardiologist Francisco Yun, M.D., “This improves the patient’s symptoms and takes the excess strain and stress off the heart muscle. TAVR avoids the need for opening the patient’s chest and putting them on a heart-lung machine.”  

But the procedure with Guler would be special: the first performed in Silver Cross’ new Cardiac Hybrid Room, part of the $22 million Cardiac Surgery Facility that opened at the end of March. The procedure team was led by Drs. Ramana, Yun, Phil Alexander and David Garcia. 

Guler said he heard about the possibility of being the first TAVR patient at Silver Cross during his pre-surgical testing. 

When he was wheeled into the operating room on April 12, Guler recalled, “There were a lot of people around; in the operating room and behind the glass. I guess everyone wanted to be part of it.” 

“There were Silver Cross staff members who had never seen a TAVR procedure performed but had put in a tremendous effort over the last year,” said the team’s cardiovascular surgeon, Dr. Alexander. 

“It was an exciting day for the Silver Cross team who really did an amazing job to have those two hours of the first TAVR procedure at Silver Cross go as smoothly as they did,” added Dr. Ramana. “This process only can start with astute physicians like Dr. Nawrocki and Dr. Stella. The key is for patients and doctors to keep an eye out for and identify heart valve disease and appropriately refer the patients for testing and possible curative therapy. And it is immensely important to our Heart Team that we provide cutting-edge technology to our community.” 

A benefit of TAVR compared to open heart surgery is a typically quicker recovery period compared to those who have an open-heart procedure. Several hours after surgery, Guler was sitting up having some dinner. A few hours later, he walked with help to the bathroom and then hit the hallways for a jaunt with assistance.  

He was discharged home the next day to recuperate, and now is waiting for tests results to show he’s ready for cardiac rehab three times a week. 

Still, Guler knows he has a way to go. 

“Dr. Ramana said I’ll feel better by Memorial Day, even better by the Fourth of July and great by Labor Day.” 

Guler said he would definitely recommend TAVR to others who qualify for the procedure. They’ll get great care at Silver Cross, he said, but he knows being the first TAVR patient at the hospital got him some extras. 

“They gave me a balloon, some candy and a card signed by everyone involved in the surgery,” he said. “That was nice.”