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Pat Miller, of Billings

Pat Miller, of Billings, meets with Dr. Jason Fitzgerald after her minimally invasive aortic valve replacement.

Two months ago, Pat Miller relied on four to six liters of oxygen per minute for survival and could barely pad across her one-bedroom apartment.

That’s about twice the amount of oxygen someone with emphysema or COPD would use.

“I had no strength or energy,” the 85-year-old Miller said. “I wasn’t able to take my own shower. I couldn’t breathe.”

She existed like that for two years, not living.

Now she’s planning to dance at Christmas, a waltz at the Cozy Corner Bar in Lavina.

The Billings woman has aortic stenosis, a valvular heart disease that affects 1.6 million people in the United States annually. It occurs when the heart’s aortic valve narrows, obstructing blood flow from the heart to the rest of your body.

Traditional open-heart surgery has long been considered the remedy for most aortic stenosis patients, said Dr. Jason Fitzgerald, a cardiothoracic surgeon at St. Vincent Healthcare. But more often, patients deemed inoperable or not healthy enough for surgery may be candidates for a procedure called transcatheter aortic valve replacement (TAVR), which has been offered at St. Vincent since April.

St. Patrick Hospital in Missoula also offers the procedure.

Since April, Fitzgerald and Dr. Robert Terry, an interventional cardiologist, have performed 25 TAVRs; Miller was patient No. 19.

Because of her age, Miller was considered too high a risk for open heart surgery, making her a prime candidate for the one-hour procedure.

This minimally-invasive surgical procedure, which received FDA approval about two years ago, repairs the valve without removing the old, damaged valve. Instead, it wedges a replacement valve into the aortic valve’s place. Similar to a stent placed in an artery, the TAVR approach delivers a fully collapsible replacement valve to the valve site through a catheter. Once the new valve is expanded, it pushes the old valve leaflets out of the way and the tissue in the replacement valve takes over the job of regulating blood flow.

Miller underwent the procedure on Oct. 2.

She no longer relies on oxygen, a wheelchair or assistants to help her get through the day.

“It’s just such a thrill to feel human again,” she said. “I can walk all over my apartment without that damn oxygen hose all over the place.”

She also enjoys the independence she has regained from not relying on others to help her.

Though there are no guarantees, Fitzgerald said Miller could easily live to be 100.

“The best thing about it is the quality of life she has now,” he said. “Every time we do this, it just blows me away.”

Though TAVR has been FDA-approved for two years, Fitzgerald said it took St. Vincent Healthcare time to put in place the infrastructure needed to perform the procedure. Part of the infrastructure included the $4.5 million, 1,200-square-foot hybrid operating room that opened in January. The space, the Steve and Debbie Reger Hybrid OR, integrates state-of-the-art imaging technologies in an operating room environment that combines technology traditionally housed in the radiology center with the operating room. It also allows for greater collaboration among surgeons and physicians.

Had Miller not had access to the procedure at St. Vincent Healthcare, she would have had to travel to either Missoula or Denver, she said.

“I don’t think I would have survived the trip,” she said.

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