It was all the way back in the 1960s that doctors performed the first human-to-human heart transplant, but as big a deal as that was, there were no other significant advancements for decades after.
Then transcatheter aortic valve replacement, or TAVR, came along around 2012, allowing physicians to replace faulty heart valves in patients with a minimally invasive technique that often saw patients going home the next day. It was a huge step forward.
This week, in recognition of American Heart Month, interventional cardiologist Dr. George Isa paid a visit to The Lake 94.7-FM studios in Covington to talk with host Charles Dowdy about St. Tammany Health System’s first-on-the-Northshore TAVR program and why it’s such a game-changer for local heart patients.
Listen to their conversation in the embedded player below or at The Lake-94.7 website. You can also find a transcription of it below, lightly edited for clarity and length.
Charles: Got guests in the studio. It is a Thursday. Our friends from St. Tammany Health System are here. Melissa, how are you?
Melissa: Good morning Charles. I am excited to be here.
Charles: I am excited that you are here. … Dr. Isa is here as well. Give me a little background on who you are real quick, if you don’t mind.
Dr. Isa: I am an Interventional cardiologist with St. Tammany (and) Ochsner Health System. Pretty much a New Orleans boy. Been here my whole life. Trained at LSU New Orleans and did my fellowship at Ochsner and been here since 2001. I am currently the medical director for the Structural Heart Program at St. Tammany.
Charles: All right I am going to ask you questions about that and let you educate us on that, but real quick: passions, hobbies, interests, things you like to do outside of work? Or are you not allowed to have those.
Dr. Isa: Oh, a little good Bourbon here and there. I work really hard and hang out with the family. I have a 4-year-old girl at home and a 24-year-old boy at ULL.
Charles: Congratulations on both. We are glad you are here. So, in a nutshell, this is a month that is important, right? As far as the heart goes? Talk about that first.
Dr. Isa: It is American Heart Month. The American Heart Association always celebrates Heart Month to try and stamp out heart disease as much as we can and to try and raise awareness.
Charles: The location where we live is good business for people that are in the heart business, right? I mean, unfortunately.
Dr. Isa: Unfortunately, and fortunately, yes. It is a double-edged sword, unfortunately.
Charles: We live well, and there are implications for that long-term. So, let’s start there if you don’t mind. Let’s talk just a little bit about lifestyle. Use me as the example. I am a 51-year-old male. I think I’m in decent shape. Where should I be and what should I be doing when it comes to heart health?
Dr. Isa: I always laugh because you know there are always studies that prove everything, and in the age of the internet there is a study to prove anything. But if you go back 45 to 50 years, it still boils down to exercise and diet – a low-fat diet, exercise. The Mediterranean diet has always been proven to be beneficial. You are in good shape for your age. You are thin, you exercise, don’t smoke, and those are the number one steps. Live a happy life.
Charles: How do you know I don’t smoke?
Melissa: You can look at your face and tell you don’t smoke.
Dr. Isa: Your fingernails. Fingernails give it away sometimes.
Charles: Talk about your job title for just a second, and then let’s kind of wander off into what exactly it is you do for St. Tammany Health System.
Dr. Isa: So, I am an interventional cardiologist. We treat all forms of heart disease and do stents from your carotid arteries all the way down to your legs and everything in between. Again, been here for 21 years. We also now do the Structural Heart Program, which is the TAVR, replacing the aortic valve without having to do surgeries. It is like an angiogram going through your leg.
Charles: All right I am going to pretend like I understand all of that. But your job has gotten easier hasn’t it? Not over the years (but in terms of) technology you guys employ.
Dr. Isa: Without a doubt, yes. Things we did back in 2001 that was just high-risk, today we are like, that is bread and butter.
Charles: We have talked about this a good bit with folks from your health system over the last couple of years: Are you seeing instances where people are not doing what they have needed to do the last couple of years? Having to see you with more regularity or no?
Dr. Isa: Honestly, people are doing better. People are eating better, and smoking has gone considerably down. So, it is just, in this area, the population is growing, so we are all still busy – or busier because of more population – but in general people are healthier.
Charles: This is kind of out of left field, (but) as far as when someone is having an episode or someone is having a negative reaction, what should they look for? I mean. in terms of how they feel or when they should seek your help.
Dr. Isa: So classic signs of what we call ischemia – when are developing a blockage – I tell all my patients: Can you do now what you did three months ago? People that tell me, ‘Boy, I used to go on a treadmill and do five miles. You know, last two weeks, 15 minutes I’m pretty much out of it. I am doing two miles.’ Everybody has got a bad day at the gym, but if it has been going on for two to three weeks, that is a red flag. Or if I am at home and suddenly my chest is heavy and I can’t breathe, I am short of breath and nauseous. Well, come to the emergency room.
Charles: I don’t know if I am having a heart attack, but sometimes I feel like it on that treadmill.
Dr. Isa: We use Walmart, honestly. People laugh, but it is the Walmart stress test. People tell me, ‘Oh, I used to walk Walmart, the big Supercenter, wall to wall and did fine. Now I’m walking halfway across Walmart and I am out of breath or my chest hurts. It has been going on for a few weeks.’ Yeah, you need to see your cardiologist.
Charles: This idea that we used to have to go in and crack open the chest and do all that. Do you still do it?
Dr. Isa: (Open-heart) surgery still exists and will exist, but starting in 2019, St. Tammany was the first on the Northshore to offer what we call the TAVR procedure (in which) we can replace the valve in your heart just by going through your leg, like an angiogram. So instead of cutting your chest open, like people think of having open-heart surgery, this is just a half-millimeter incision right here in your leg, and (we) replace the valve that way. The person goes home the next day.
Charles: When you trained years ago, to think you’d be doing what you are doing now.
Dr. Isa: The first heart replacement surgeries were in 1961, if I remember correctly. TAVR, the first one was done in 2002. So, nothing changed in all that time. And then 2002 was extremely experimental. It wasn’t really approved in the United States until 2012. It was only for people who were too sick for surgery with aortic stenosis. Eighty percent of them passed away within three years. With TAVR, drop that number down to 30%. So, a big change.
Charles: What have we missed? Is there anything else that you want to talk about as far as the heart goes before, we wrap this up?
Dr. Isa: I wanted to say something that we are really proud of at St. Tammany. We are the first hospital on the Northshore to have ACC accreditation, which is the American College of Cardiology Accreditation, for our TAVR program – and only the second one in New Orleans metro area.
Charles: So then as far as somebody going through life. When is the first time they interact with you? Does it matter?
Dr. Isa: Oh geez, I have patients from as young as 17 years old to 101 years old.
Charles: All right, so it is a little bit of everything. The main thing is they are going to go through another doctor generally before they are going to be in front of you.
Dr. Isa: In general, yes.
Charles: Ok, what can people be doing. We talked about diet and exercise. Those are the big ones, right?
Dr. Isa: Those are the big ones. And don’t smoke.
Charles: Oh, we hadn’t talked about that.
Dr. Isa: The big three. Put down the cigarettes.
Charles: Melissa, you had a couple of things you wanted to touch on.
Melissa: Yes, two things, Charles. We had mentioned part of the reason Dr. Isa is with us today is we are putting a focus on heart health all through February for obvious reasons. It is Heart Health Awareness Month. As part of that, St. Tammany Health System has the Be Well Bus. It is all over town all the time, trying to take healthcare out into the community. So, for the month of February, we have got the Be Well Bus doing heart health screenings. We will be at State Farm Feb. 17, that is today at 11. And we will have a CPR class for the public on Feb. 19 at the hospital. The Be Well Bus will be back doing heart screenings at the Pelican Athletic Club on Feb. 21t. All of that is available at sttammany.health.