Introduction
Robert Costello was a trucker for UPS for 40 years and loved every minute of it. He enjoyed the freedom of travel and driving on the open roads. During much of that time, he and his wife Sharon and their three children lived in Virginia and for a time in West Virginia. After his retirement in 2007, the couple were able to spend much more time with their family and friends, but a warmer climate (and the promise of no snow!) prompted them to move to Florida in 2016.
A couple of years ago, Robert began noticing that he was getting short of breath during regular activities. Not wanting to ignore these symptoms, he made an appointment with his doctor at the time who completed numerous lung-related tests. The tests revealed no serious concerns with Mr. Costello’s lungs, so the doctor continued to monitor him over the next several months. But the shortness of breath continued, so Robert’s doctor referred him to Dr. Avinash Khanna, Interventional Cardiologist at Lakeland Regional Health because he felt the difficulty breathing could be caused by a heart issue.
Consulting with Dr. Khanna and Dr. Medina
Dr. Khanna performed an echocardiogram (Echo – an ultrasound that shows the heart structure and blood flow). The results showed that he had some minor narrowing of his aortic heart valve, which at that point did not require any intervention, so Dr. Khanna continued to monitor Mr. Costello for changes.
After a few months, Mr. Costello noticed that shortness of breath had worsened; in fact, it had become difficult even to walk from his house to his truck without getting winded, so he again made an appointment to see Dr. Khanna.
During this follow-up appointment, the echocardiogram showed more significant narrowing in his aortic heart valve, so Dr. Khanna suggested the possibility of a Transfemoral Aortic Valve Replacement (TAVR). A TAVR is designed for those who have severe aortic stenosis (narrowing of the heart valve) and who would face more risks from a standard valve replacement surgery. Aortic stenosis is one of the most common and most serious valve conditions, and the TAVR procedure allows physicians to replace a diseased aortic valve without open-heart surgery. In a TAVR, a new valve is inserted through an artery and is placed over the diseased valve. Unlike open heart surgery to replace or repair a valve, this minimally invasive procedure usually leads to a quicker recovery, requiring less time in the hospital.
Mr. Costello met with Dr. Khanna and Andres Medina, MD, Cardiovascular Surgeon at Lakeland Regional Health to discuss the possibility of a TAVR. Both Dr. Khanna and Dr. Medina are specially trained in performing TAVR procedures at Lakeland Regional Health. After the physicians reviewed his case, it was determined that Mr. Costello was a good candidate for the TAVR and he was scheduled for the procedure on May 6, 2021.
As of mid March, the Heart Center team at Lakeland Regional Health completed its 500th TAVR procedure. Dr. Medina helped pioneer the TAVR procedure and served as one of two surgical investigators participating in the PARTNER trial for the state that led to FDA approval for TAVR. Dr. Medina performed the first TAVR procedure in Florida and has since evaluated hundreds of successfully completed TAVR cases and proctored other surgeons as they learned to master its techniques.
The TAVR Procedure
Mr. Costello never thought he would have to go through a procedure like this. Up until this time he had only had minor procedures, so he was naturally very concerned, but the care team helped put his mind at ease. He was especially appreciative of the care he received from Moezza “Moe” Butler, an Advanced Practice Registered Nurse (APRN) who works in the Cardiology Department at Lakeland Regional Health.
“Moe took the time to explain exactly what would happen each step of the way,” said Mr. Costello. “That meant a lot to me because I was scared. With Moe’s help, I was able to relax and not be so worried about the procedure.”
On the day of surgery Robert and Sharon arrived at the hospital for the procedure. Sharon stayed for the surgery and the day after, but due to COVID-19 safety restrictions, Mr. Costello mostly relied on the care and comfort of the team members during his 2 days in the hospital. He describes the care he received as excellent from the nurses, physicians, clinical care teams. Each one helped him during the early days of his recovery.
“I am thankful that the Heart Center team was there when I needed them and had the ability to do this work. It is a miracle of modern-day medicine and it was much easier than I thought. I had very little pain from the procedure,” said Robert.
Recovery
Mr. Costello is getting stronger each day and is now able to do more of what he likes to do and without the shortness of breath. To help strengthen his heart, he has been attending weekly cardiac rehabilitation sessions at the Cardiac Rehabilitation Center located at Lakeland Regional Health’s North Campus. The Cardiac Rehabilitation team helps people recover from heart-related surgeries or events through proper exercise and movement.
Mr. Costello says of his choice to go with Lakeland Regional Health, “It was important to me to go to a place with a lot of experience doing this procedure but what made it even better was the exceptional care from everyone on the team during my hospital stay and even now during my rehabilitation and recovery.”
