Algonquin garden blooms thanks to Northwestern Medicine physician

The summer and early fall blooms of Harry Piehls' dahlias are an annual reminder that he's received a second chance at life.

A self-admitted “big baby” when it comes to surgery, the Algonquin resident was apprehensive about treatment for a heart valve that had become too stiff to open or close properly. But when the 80-year-old became too weak to enjoy his favorite hobby of gardening, he knew something had to be done.

Piehl was experiencing aortic stenosis, in which the valve is narrowed and restricting blood flow to the heart. Affecting 1 in 8 people over the age of 75, it is the most common type of heart valve disease. The valve needed to be replaced, but Piehl didn't want open heart surgery. Instead, his physician suggested a minimally invasive treatment option called Transcatheter Aortic Valve Replacement (TAVR).

“Once the aortic stenosis starts limiting independent day-to-day living, there is a problem,” said Elizabeth M. Retzer, MD, interventional cardiologist at Northwestern Medicine Bluhm Cardiovascular Institute at McHenry Hospital. “Harry was so weak he could barely walk out to the garden let alone tend to it.”

However, an angiogram, the test required to see if Piehl was a candidate, made him nervous. On the day of the test, which happened to be National Flower Day, Dr. Retzer greeted Piehl with two bags of flower bulbs. Dr. Retzer, who comes from a family of farmers, gardens to relieve her own stress and has hundreds of dahlias. She knew the bulbs were the perfect way to connect with Piehl.

“She told me plant these and when they bloom you will think of me,” said Piehl. “Talking flowers with Dr. Retzer put me at ease and I was in and out before I knew it.”

Piehl was relieved to learn he was a good candidate for the TAVR procedure and within a few weeks he was back at Northwestern Medicine McHenry Hospital, this time with much less apprehension.

During the procedure, Dr. Retzer inserted a catheter (tube) up to the heart through an artery in the leg. The TAVR valve is compressed and advanced along the catheter until it reaches the diseased aortic valve. A balloon on the catheter is expanded to secure the TAVR valve and push the diseased valve out of the way. The TAVR valve then takes over the job of regulating blood flow from the heart.

“Aortic stenosis is progressive so patients slowly slow down and don't realize how bad their symptoms have become,” said Dr. Retzer. “Once you remove the problem, they feel like a million bucks and within weeks are back to doing what they love.”

Transcatheter techniques like those used in TAVR allow the procedure to be performed while the patient's heart is still beating, eliminating the need for the heart-lung machine and an open-heart operation.

“The TAVR valve is made from a cow, so the first thing I did when I opened my eyes was say 'Moo!' to my family,' laughed Piehl. “The procedure was so easy for me. Getting my teeth cleaned was more uncomfortable.”

The TAVR team at Northwestern Medicine McHenry hospital recently reached a milestone, completing its 200th TAVR procedure. The team is composed of an interventional cardiologist, cardiac surgeon, a cardiac imaging specialist, valve clinic coordinator, structural heart nurse and a structural heart nurse practitioner.

“Milestones like this demonstrate our continued commitment to providing innovative and minimally invasive cardiovascular care for our patients close to where they live and work,” said Dr. Retzer.

Piehl is now undergoing cardiac rehabilitation at Northwestern Medicine Huntley Hospital to fully regain his strength back. But he is already feeling well enough to harvest his garden for a bounty of tomatoes, cucumbers and potatoes.

“I was too weak to plant my garden in the spring. My neighbors and friends had to help,” said Piehl. “Now when I look at the dahlia's blooming, I'm reminded of how Dr. Retzer helped me get back to my life.”

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