CRMC Attains Milestone with 100th TAVR Procedure

This Level of Cardiac Care Makes All the Difference for Patients Like Lem McSpadden

In January, the CRMC heart program reached the milestone of having performed its 100th transcatheter aortic valve replacement (TAVR) procedure.


The TAVR procedure is a minimally invasive alternative to open-heart surgery for severe aortic stenosis (narrowing of the aortic valve) for patients who qualify. CRMC also offers traditional heart valve surgery. The first TAVR at CRMC was performed in March 2017.


“Getting the program going required a multidisciplinary team approach that basically involved everybody from the staff in same-day surgery to the cath and vascular lab staff to anesthesia to the surgeons to the cardiologists to the noninvasive imaging team that helps out with echocardiograms to the ICU taking care of these patients to the nursing staff to cardiac rehab,” said Dr. Christopher Adams, an interventional cardiologist with Cookeville Regional and Tennessee Heart.


Along with Dr. Adams, the team that performs TAVR procedures at CRMC includes interventional cardiologist Stacy Brewington, MD, and cardiothoracic surgeons Lewis Wilson, MD, and Tim Powell, MD.


In the year since the TAVR program began, improvements have already been introduced. Physicians are now performing the procedure under conscious sedation instead of general anesthesia, which allows most patients to go home within 24 to 48 hours after the procedure.


“For some patients, surgery is still the right answer, and for many patients, TAVR is the right option,” said Dr. Adams. “That’s why we meet as a team to discuss and decide the best option for each patient. Decisions aren’t simple, but we take the patient’s own personal thoughts into account, and we try to outline everything and come to an agreement as to which is the best course of treatment.”


Lem McSpadden of Cookeville is one of those patients for whom TAVR was the right option. His cardiologist, Alex Case, MD, had been monitoring a leak in his aorta for several years.


“In this last go-round, it went from moderate to serious, so Dr. Case told me we were going to have to do something soon,” said McSpadden. “That’s when all of these great doctors got together and figured out what needed to be done and how to do it.”


First, Dr. Brewington performed a heart catheterization and discovered major blockages in four of McSpadden’s arteries, so he placed four stents. After McSpadden recovered from that procedure, Drs. Adams, Brewington and Wilson performed the TAVR. McSpadden was one of the 5-7% of patients who also needed a permanent pacemaker, so Dr. William Wassynger later implanted that device.


McSpadden says he chose to stay in Cookeville because of the trust he’s developed during the many years he’s been a patient of Dr. Case and other CRMC physicians.


“I’m just blessed that we have the physicians and the facilities that we do here,” said McSpadden. “Can you imagine if I had to go to Nashville for all of the different focuses of the cardiologists’ specialties that I needed? They were perfect here. They did everything they needed to do.”


Before the procedures, McSpadden had gradually become so ill and exhausted that he was sleeping around 20 hours a day and was only able to perform one or two activities. Now he’s sleeping only about eight hours a night and can once again do the things he used to love, like eating out, visiting family in New Orleans, and doing woodwork in his shop.


“I never thought I’d be able to feel this good again,” he said. “Sometimes you get real low, and you don’t know if you’re going to make it or not. It was truly life and death, and they saved my life. They got in and gave back what I was missing.”


For more information about TAVR or any of the other structural heart procedures offered at Cookeville Regional, please call The Valve Clinic at (931) 646-4093.