New heart valve gives 82 year-old new life
In February 2016, during a routine examination, Angela Jaschke (82) was diagnosed with severe aortic stenosis. Calcification of her aortic valve was so severe that only a 3mm wide opening was left. She was given a new heart valve using the minimally invasive technique of transcatheter aortic valve implantation (TAVI). And because she was in such good physical condition after decades of sport, she was able to take up sport again and coach her water aerobics group only six weeks after the operation. Her advice for others with the same condition is as follows: “Get as much information as you can, talk to the doctors and ask about the TAVI method, which is easier on the body.”
Mrs Jaschke, you were a competitive swimmer when you were young and you are still very active as the voluntary coach of a water aerobics group. What do you get out of sport?
I started at the age of 5 and basically spent 15 years of my childhood and teens in the water. I have been coaching the water aerobics group of the German Red Cross for 22 years now. What do I get out of sport? Inner peace. Joie de vivre – with sport I can enjoy life to the full. And inner balance: when I get out of the water I have energy, balanced energy.
What else in your life is important to you?
My husband is very important to me and what we do in our life together: we are both creative types, we enjoy going to the theatre and to concerts, we like literature and read a lot, and we enjoy eating out. My family is very important to me. And, of course, our friends.
You are a very dynamic person: it’s scarcely imaginable that not very long ago you were diagnosed with severe calcification of the aortic valve, or aortic stenosis. When and how were you diagnosed?
It was at the end of February 2016, during a routine examination. Suddenly my doctor asked me “tell me what the problem is”. But I didn’t have any problems and felt absolutely fine. He kept on asking: “High blood pressure? Does your heart race or are you short of breath?” But I simply didn’t have any of that! Then he explained I had severe calcification of the aortic valve and had to be operated on immediately. A couple of days later they did further investigations at the University Clinic in Mainz and they told me that because of the calcification, there was only a 3mm wide opening in my aortic valve for the blood to flow through. Because of that I wasn’t even allowed to return home in my condition and they had to give me a new aortic valve as soon as possible.
What happened next?
I had to stay in the university clinic and pestered the doctors with questions. I wanted to know exactly what they were going to do. Professor Schulz explained the minimally invasive TAVI method to me and a surgeon explained classic aortic valve replacement when the chest is opened up. I soon realised that I wanted them to use the TAVI method for the operation. My body was otherwise very fit but it’s also a question of age: when you’re 80 years old, they don’t like opening up your chest. Even after I’d made my decision, I still asked the surgeon endless questions. As a lay person, I needed to be able to visualise how the operation would be done. It’s important, because knowledge lessens your fears. And a good relationship with your doctor is also important, that the doctor takes time to talk to you so you can build up trust.
And how was the transcatheter aortic valve implantation (TAVI) done in your case? Via the transfemoral aorta?
Yes, exactly. The catheter containing the new heart valve, which is folded up very small, is inserted by the cardiologist through the main artery and then moved up through the body to the correct position in the heart, where the calcified valve is located. The new valve is then opened up using a balloon, it presses the old one against the artery wall and starts working. Then catheter is then removed. Under full anaesthetic you don’t notice a thing, not even the small incision of a couple of centimetres that is made to introduce the catheter. The TAVI method is less invasive because they don’t have to open up the chest and the heart doesn’t have to be stopped. Of course, they have to check in advance whether there is any other calcification so that the catheter with the new heart valve can actually “get through”.
What happened after the operation?
I was in the clinic for another five days and then four weeks in a physical rehabilitation clinic. It was awful at first: I had problems opening my eyes and had to learn to walk again. But if you follow the therapist’s instructions and try to help yourself, then it works. That’s why I asked for psychological help in that situation. With a psychologist at my side I did in fact feel better. Once I was able to walk again properly, that was about two weeks after the operation, I was able to start doing exercises in the exercise room. Of course, the exercises were very gentle at first, but after two weeks I was fit as a fiddle and from then on, I could exercise on my own. And another two weeks later – six weeks after the operation – I was back at the poolside, coaching my water aerobics group.
How did you cope with the sudden diagnosis and where did you find the strength to deal with the rehabilitation process?
At first, I have to admit, I didn’t believe it and then everything went so fast. So, I didn’t really have time to indulge in negative thoughts. I was really happy that my husband was with me during the first difficult weeks of the rehabilitation programme, he was so kind and patient! In situations like that you have to try and find the right balance: first of all you need patience for things that you have to build up again. But you also need the drive to actually do it. This combination of doing, or of doing and patience together, is very important.
How would you describe your quality of life now?
It’s excellent! I’d say that I’m in excellent condition and can enjoy life to the full. Of course, I know when to be careful: I have to be more careful after physical exertion, for example when I have a cold. I make sure I’m completely better and take a longer break from exercising. Then I start with easy exercises and gradually build up my fitness again. You have to know these things and take note of them because you have to go easy on your heart. But my physical condition allows me to dance, swim, run – I can do everything!
What made you participate in the “Body Proud” campaign?
All the things I do relating to aortic valves are because I want to allay other patients’ fears. And I want to help publicise the TAVI method because it’s not so well known at present. Of course, I can’t say anything about the medical side of things but I can tell people about my experience and how I felt. It’s important that patients speak to each other.
What would you recommend to other patients who are diagnosed with aortic stenosis?
Make sure you get enough information, talk to the doctors and also ask about the TAVI method, which is less invasive. It’s certainly something the general public knows very little about and probably it seems a bit scary because it’s difficult to imagine a catheter containing a heart valve being moved through your body. It’s easier to imagine the chest being opened. But if conditions are right for a patient, then they should certainly consider the TAVI method.
How would you finish the sentence “I’m proud of my body because…”
Other people say “you can be proud of your body”. I myself say “I am thankful to the depths of my heart that I have reached 82 years of age in this condition.”