Honolulu resident Jim Nabors, best known for his 1960s television role as Gomer Pyle, was among the first patients in Hawaii to get a heart valve replacement using a new procedure that avoids the stress of open-heart surgery.
Nabors, who turns 82 next week, said in an interview Wednesday that he had suffered for four years from the effects of aortic stenosis, a severe narrowing of the heart valve that causes fatigue and eventual heart failure.
"You just get very weak," said the actor known for his rich baritone. "You don’t want to do anything and you’re mostly in bed all day. It’s really no way to live. I usually am the Energizer Bunny."
Nabors had the operation at the Queen’s Medical Center on May 29 and said he is already doing much better.
"My strength is coming back. One of the things I noticed first is my thinking was clearer. My body was getting blood. The recovery is amazing. It had me on my feet the very next day. It’s phenomenal that they can do that these days. I wouldn’t certainly be here."
THE WARNING SIGNS
Symptoms of aortic stenosis, a severe narrowing of the heart valve:
>> Extreme fatigue >> Dizziness >> Chest pain or pressure >> Shortness of breath >> Rapid or irregular heartbeat >> Fainting
Source: The Queen’s Medical Center
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Nabors missed his annual singing of "Back Home Again In Indiana" at the Indianapolis 500 during the Memorial Day weekend to undergo the surgery.
The procedure is an alternative to the more invasive open-heart surgery that involves exposing the heart with an incision. Nabors had the heart valve inserted via catheter through the groin, a method approved late last year by the Food and Drug Administration for heart disease patients previously deemed inoperable.
Queen’s, the only Hawaii hospital approved to perform the procedure, has successfully completed the operation on six patients in the past month.
Patients with aortic stenosis are generally over 70 years old with multiple medical conditions and often are too fragile to survive traditional open-heart surgery. The FDA is considering broadening the type of patients eligible for the procedure, offered at 120 U.S. hospitals, to include additional high-risk cases.
The most dramatic difference between the less-invasive technique and open-heart surgery is the recovery time, with patients up and walking the day after the operation and discharged within two to five days, according to Christian Spies, Queen’s medical director of cardiac invasive services.
"The only recovery is actually from the effects of anesthesia and from the incision we make in the groin. From a heart point of view, there’s really no recovery needed because the heart — all of a sudden without hurting it with any surgery — in a way is happy," Spies said. "Patients feel relatively instantaneous improvement in their symptoms."
Aortic stenosis occurs when the aortic valve doesn’t properly open and close typically due to a buildup of calcium, restricting blood flow from the heart. This, in turn, adds pressure within the heart and weakens the muscles, which substantially increases the risk of heart failure.
"To have this new option for these patients to extend their lives, extend their quality of living has been remarkable," said cardiothoracic surgeon Jeffrey Lau, chief of the Queen’s Department of Cardiovascular Diseases.
Lau said the method won’t replace open-heart surgery, "but it’s definitely going to open up new doors, new pathways for patients to receive better treatment. We simply can’t duplicate the faster recovery. For somebody who has open-heart surgery … it’s going to take at least two to three months before they’re up doing regular activities. With this kind of treatment, you’re up and about the next day so it’s a huge amount of savings in how fast they’re recovering."
The new technology, similar to heart surgery through the groin using stents to prop open clogged arteries, involves a physician guiding a catheter, or thin tube, with a new valve attached through the femoral artery in the thigh.
The valve is anchored inside the aorta, immediately allowing unobstructed blood flow.
"Open-heart surgery to replace the aortic valve is the standard of care. It has been done for decades and it’s a very good technology. However, there are certain patients where traditional surgery is just too risky … simply by virtue of age alone," Spies said.
"This has been shown to benefit patients greatly not only in terms of prolonging people’s lives but also to improve quality of life."
In Hawaii, there are between 400 and 500 patients per year with severe aortic stenosis, he said.
More than 200,000 Americans live with aortic stenosis, which often develops into debilitating symptoms that can affect daily activities such as walking or climbing stairs and can reduce a patient’s life expectancy. The trend is only expected to worsen as the nation’s population ages.
Nabors feels fortunate to have been among the few to have benefited from the new procedure.
"I keep surviving these things. I had a liver transplant 18 years ago, and I put in a pacemaker, then I had a new knee and now I have a new heart," he said. "I’m amazed that I’m still here. I’m very blessed. All I can tell you is … golly!"