When Winifred Pearson arrived at Novant Health Huntersville Medical Center struggling to catch her breath, doctors knew right away her chances of surviving the weekend were not good.
A leaky valve was quickly diagnosed. Pearson’s heart would never recover without immediate attention. So on that Friday in August 2023, Pearson, 79, was rushed to Novant Health Presbyterian Medical Center in nearby Charlotte. The leaky valve, combined with a preexisting chronic obstructive pulmonary disease, had caused her organs to begin failing.
Given her age and frail condition, “She would have died had she gone through open-heart surgery,” said Dr. Daniel Pu, interventional cardiologist with Novant Health Heart & Vascular Institute - Elizabeth.
And yet, there was hope: She was eligible for a heart-valve replacement procedure that did not require major incisions. In medicine, those procedures are often referred to as “minimally invasive.”
Compassionate care for your whole heart.
The operation is known as transcatheter aortic valve replacement (TAVR), a treatment that avoids opening the patient’s chest. Instead, TAVR uses a catheter to insert a new, collapsible heart valve, which expands inside the existing one to regulate blood flow. The process resembles how a stent expands inside an artery.
The first TAVR (pronounced TAV-er for short) was performed in 2011. Just 10 years later, there were 92,000 performed in the U.S. in 2021. Novant Health was among the first medical systems in the country to offer TAVR. And it’s giving many patients too elderly to withstand open-heart surgery another chance.
But in Pearson’s case, there was a hitch: Time was running out. Pu’s medical team was up against an urgent — what some might consider impossible — deadline. They had only the weekend to tackle what often requires two-weeks or more of planning, given the many doctors, team members and resources required.
“Everything had to perfectly line up in order for us to perform it safely,” Pu said. He told Pearson that a successful outcome was not guaranteed.
Top scores for safety in NC
Novant Health just received the most ‘As’ for patient safety in North Carolina from The Leapfrog Group. That includes Rowan Medical Center. With a focus on safety, quality and patient experience, the national, industry-leading nonprofit, evaluates and assigns letter grades ranging from A to F to hospitals across the country. Novant Health’s hospitals with “A” grades outperform 70% of hospitals nationwide for safety and quality.
“I wasn’t nervous,” she said. “I know that sounds crazy, to hear you might die and yet all of a sudden you feel peace around you.”
But behind the scenes, it was a scramble. Pu rapidly assembled a medical team of eight and alerted Pearson’s son David, who hopped the next flight from Qatar, in the Middle East.
And the question was: Would Pearson ever see her son again?
Coming to America
Pearson’s journey to this moment all started one morning when she woke up struggling to catch her breath.
“I had no idea how ill I was,” she said. “The first thing I noticed was that I was getting exceedingly tired, and more so than usual. I really didn’t have a lot of pain, and then it progressively got worse.”
Pearson had undergone a heart-valve replacement many years before. Those valves can last up to 20 years, depending on the patient’s condition. But, Pu said, Pearson may have delayed necessary care by waiting too long between follow-ups with her cardiologist, given the medical history.
In the mid-1960s, Bridget Winifred O’Dowd left Ireland alone for the U.S. Many of her friends were getting married, but she decided she wasn’t ready for all that — even though she was engaged herself. At 21 she broke it off and was determined to travel for one year, even though her pockets were nearly empty.
“I picked the furthest place on the map, which was America,” she said, and ended up in McLean, Virginia, working as an au pair.
Pearson has lived in the U.S. ever since. She eventually married, and became a mother to two sons whom she raised with her husband until his death.
Grateful to be alive
Open-heart surgery, cracking open a patient’s chest to operate on the heart, is far more taxing on a patient’s recovery than TAVR. And before TAVR, elderly patients who would not survive open-heart faced a shorter life span and lower quality of life as well.
Pu performed what’s known as the transfemoral approach, which requires only a small incision to insert the new heart valve through the femoral artery, located in the groin. From there the valve is snaked up through the body to the heart.
“The procedure requires a lot of planning beforehand, in terms of looking at the patient’s CT scans and measuring their valve sizes,” Pu said.
Preparation often takes weeks. But the TAVR itself usually lasts an hour or two, and patients go home the next day. And in Pearson’s case, everything came together as Pu’s team successfully completed the procedure on a Sunday.
“I am so grateful to Dr. Pu and the people who took care of me; they are absolutely top-notch,” Pearson said. “It’s a great relief to have faith in your doctor and know that you’re going to be alright.”
Recovery has meant regular appointments with her doctors, and a gradual return to the physically active things Pearson loves most: exercising at the gym and tending to her rose garden.
“My friends and my sons say I’m a miracle,” she said. “I’m looking forward to getting back in my garden — and not losing my breath.”
Daniel Pu joined Novant Health in 2020. The Ohio State University College of Medicine graduate treats cardiovascular disease and practices interventional cardiology, a field that has fascinated Pu for much of his life.
“My dad is a cardiologist, so I had a lot of exposure to the heart,” Pu said.
Pu completed his residency in internal medicine at New York Presbyterian/Weill Cornell Medical Center in 2015.
At Novant Health Presbyterian Medical Center, Pu estimates that he and Dr. Oluseun Alli performed more than 200 TAVR procedures last year. Most patients are good candidates, Pu said, face a much better outcome, given the risks with open-heart surgery for people in their condition.
“I really enjoy working with my hands and with leading-edge procedures that can help patients without them having to go through a big surgery,” Pu said.