Lynn Barry was in her early 40s when she received a startling diagnosis: aortic stenosis, a condition characterized by a narrowing of the aortic valve that affects the heart’s ability to pump blood. She was told she would eventually need a valve replacement, which at the time required open-heart surgery.
“That did not sit well with me,” she says. An avid outdoorswoman, Lynn made a commitment to staying active. In the 30 years since her diagnosis, the retired stockbroker has hiked extensively in the Santa Monica Mountains; summited Mount Whitney, the tallest mountain in the contiguous United States; and trekked Nepal and Bhutan, culminating in a climb to 18,600 feet on Mount Everest, without oxygen. She was 65 at the time.
She has also been diligent about having her heart checked on a regular basis, since aortic stenosis can be deadly if left untreated. Before a 2013 trip to Tibet, Lynn saw Peter Pelikan, MD, because she needed a cardiologist to confirm her ability to hike at high altitude.
“He signed off. He said my heart was really pretty strong, but, to be sure, to come back in a year,” says Lynn. “When I had a follow-up with him, he mentioned, ‘You know, you don’t have to be so concerned. They’re coming up with a new technique called TAVR.’ ”
Late last year, Dr. Pelikan, director of the Cardiac Catheterization Lab at Providence Saint John’s Health Center and a cardiologist at the Pacific Heart Institute, introduced transcatheter aortic valve replacement (TAVR) to Saint John’s—and Lynn was one of the program’s first patients.
During the minimally invasive procedure, two cardiologists and a cardiac surgeon work together in a modified cath lab. The standard approach involves making two small incisions in the patient’s groin and feeding a catheter through the femoral artery to deliver a replacement valve to the heart. If a patient’s femoral artery is too narrow, alternative approaches include using an artery under the collarbone and a vein in the leg.
“TAVR is dramatically easier on the patient, because you don’t have to open the chest,” says Dr. Pelikan. “You don’t have to stop the heart and put the patient on a cardiopulmonary bypass pump, which activates defensive inflammatory systems in the body.”
Dr. Pelikan, who has about seven years of TAVR experience, recommends the procedure to patients whenever possible, since the Food and Drug Administration and Medicare recently approved it for patients who are considered low-risk candidates for surgery. “Studies show that for any factor you want to look at—patient comfort, stroke, heart attack, death— you’re better off having the TAVR than open surgery, which is great news,” says Dr. Pelikan. “Now we’re allowed to do this on almost all patients with aortic stenosis, not just the sickest patients.”
As the only person to formally petition Medicare to change its criteria for determining which hospitals can offer TAVR, Dr. Pelikan played a role in expanding access to TAVR in communities across the country. “Especially now, with the ability to do TAVR on low-risk patients, there is an access issue in the United States,” he says.
“We think it’s a really good thing that Medicare listened and responded and changed their criteria.”
As of June, Dr. Pelikan and the team, which includes several other Saint John’s cardiologists and interventional cardiologists have far exceeded expectations. “It’s going great,” he says. “I’m happy we’re able to serve the community here.”
Even though Lynn recently relocated to Ojai from Pacific Palisades, she chose to have TAVR at Saint John’s because she trusts Dr. Pelikan and his colleagues. “My group really is into hands-on, doctor-to-patient relationships,” says Dr. Pelikan. “We don’t put that off on allied health personnel here. We want to get to know our patients.”
Following her December 2019 procedure, Lynn spent one night in the hospital and was discharged with what she called “commonsense” instructions to rest and not lift heavy objects. “I felt total relief and an inner exuberance that the problem may have been solved,” she says. “I didn’t realize I was so stressed. It was a cloud that hung over me.”
Lynn has embraced Ojai’s outdoor lifestyle. She’s practicing plein air painting, and in early March she took her first post-TAVR hike, a guided “supermoon sunset herb walk.”
“I made sure I stayed right behind the leaders,” says Lynn. “I kept up. In the past, I would have to stop to catch my breath every 200 to 300 feet, but this time I did not have to stop at all. I went a mile, full speed ahead, uphill.”