In her 90s, her heart is back on track, thanks to TAVR

For most of her 91 years, Luc Tran has enjoyed good health.

She and her husband immigrated to the United States in 1975 to escape political persecution after the Vietnam War. She finds joy in spending time with her eight children and their extended families. She is active in her church.

Two years ago, Tran began slowing down. She lost her appetite. Already a petite 4 feet 11 inches tall, her weight dropped to 64 pounds.

“I had difficulty breathing,” she said. “I had no energy.”

Tests revealed Tran had developed fluid in her lungs. Her cardiologist, Irena Stolar, M.D., diagnosed her with aortic valve stenosis, a narrowing of the aortic valve that reduces blood flow from the heart to the body.

Dr. Stolar referred her to Wasif Qureshi, M.D., an interventional cardiologist at Christiana Care’s Center for Heart & Vascular Health, the only center in the region that integrates cardiac surgery, vascular surgery, vascular interventional radiology, cardiology and interventional nephrology under one roof.

“Replacing the valve was the only way that we could get her well,” Dr. Qureshi said.

Tran was too frail for open heart surgery. But with a positive attitude and a supportive family, she was a candidate for transcatheter aortic valve replacement, or TAVR, an innovative, minimally invasive procedure in which a new valve is placed inside the narrowed valve via a catheter guided through the artery.

Since 2011, Christiana Care’s heart team has implanted more than 500 TAVR valves, more than any other health system in Delaware.

TAVR is approved for patients considered at medium or high risk for surgical aortic valve replacement or those who are considered inoperable by the heart team. Most patients are in their 80s or older.

Dr. Qureshi and his team take a compassionate, patient-centered approach to care, encouraging patients to involve loved ones in the process.

“We want as many anchors as possible,” he said. “We have a patient from downstate who brings six family members to appointments.”

Throughout the process, Tran’s daughter served as her devoted advocate. Kim Tran, RPh, MBA, is program director of Christiana Care Metabolic Health Services and Weight Management Center.

“I think having an advocate helps the process of communicating with the team,” she said. “It helps the patient to relax and feel confident.”

As little as five years ago, Tran would not have been a candidate for TAVR because she is so tiny. But as the valves improve, more patients can be successfully treated.

“It’s a slicker valve that can go through smaller arteries,” Dr. Qureshi said.

Tran had her valve implant on Aug. 23, 2017. Her improvement was remarkable.

“When she came out of anesthesia, she was hungry,” her daughter recalls.

“From that day on, I did not need oxygen,” Tran said. “My breathing is perfect.”

Two days after the procedure, she was discharged from the hospital to the home she shares with her daughter’s family. Her children gathered from all over the country to welcome her.

Six hours after she arrived home, Tran’s husband of 71 years died after years of declining health.

“In my heart, I think he was waiting for my mother to get her valve replacement,” Kim Tran said. “Without it, I don’t think my mother would have been able to survive losing my father.”

Two weeks later, Tran was strong enough to walk in her husband’s funeral procession.

Since then, she continues to improve. She completed her Christiana Care Cardiac Rehabilitation program, and goes to physical therapy two days a week. She has gained weight, cooking her favorite meal of salmon and white rice. She goes to prayer group at her church. She has fun shopping and visiting the beach. And she is traveling again to visit family, dancing with her great grandson at a wedding.

“I thank God and my doctors every day,” she said. “I am peaceful, not worried. Because of the valve, I am good.”