Saving Lives in a Heartbeat

The Spectrum

As an undergraduate student, Rose Craven Hansen was told she could never be a nurse - her grades weren't high enough. Her adviser laughed in her face.

Now 20 years later, as a registered nurse, a master of science in nursing, as well as an adult nurse practitioner, Hansen is saving lives.

She is employed at the Kaleida Health Gates Vascular Institute on the Buffalo General Medical Campus, where she plays a major role in performing an up-and-coming medical procedure that replaces an aortic heart valve. The process is called a trans catheter aortic valve replacement (TAVR). The FDA approved it five months ago.

"I knew I could be a nurse if I wanted to be, I just hadn't tried yet," Hansen said. "I want to be an inspiration to those students not doing well. It was a struggle for me because my grades weren't good. I was lucky that I pulled it off, but I really worked hard to take all the required classes."

Hansen attended UB in 1982, and after years of not knowing what her major would be or what she wanted to do with the rest of her life, her best friend suggested Hansen follow her to nursing school.

On a whim, Hansen agreed and declared herself as a nursing major. However, she didn't have the required GPA to be accepted to UB's School of Nursing so she transferred to Millard Fillmore College: a branch of UB for continuing and professional studies. She later transferred to Daemen College where she earned her bachelor's and master's degrees.

For 23 years, Hansen has been a nurse practitioner, and she "scrubs in" and helps patients who need a new heart valve. She loves the adrenaline rush of being in the room while the procedure takes place. There are over 15 people, each with their own job working together on the operation, according to Hansen.

For the first seven procedures, a doctor from Europe came to assist the doctors at Gates Vascular Institute to facilitate the procedure and teach the staff how to correctly preform it.

"It's really helped that he has had the experience with a couple of hundred patients," Hansen said. "The room gets very nervous because [the procedure] is very intense."

The procedure involves the replacement of an aortic heart valve for patients with severe aortic stenosis.Previously it could only be replaced by open-heart surgery. Aortic stenosis occurs when the aortic valve narrows or doesn't open and close properly. This causes the heart to work harder and less efficiently. The extra stress causes the heart muscle to weaken over time and increase the risk of heart failure, according to the Buffalo General Medical Center website.

This procedure has the ability to improve the quality of life for patients who can't receive open-heart surgery.

"It's rewarding to be able to not only prolong life, but it's really just improving the quality of their life," Hansen said. "When you're 80 and not able to go through the day without the symptoms of shortness of breath and chest pain, it limits the quality of life and day-to-day activities. They can't enjoy life. We can give that back to them."

TAVR has been FDA approved for only the elderly and so far there have only been eight patients at Gates Vascular Institute. This is due to the specific screening process that perspective patients must endure. The process starts at a general heart clinic and then a variety of tests are performed, such an echocardiogram, cardiac CTA, transesophageal echocardiogram, lung function testing, and evaluating the carotid arteries for blockages, according to the Buffalo General Medical Center website.

For every 10 people that apply for the procedure there is usually only one match, Hansen said.

The procedure is for such a limited range of patients because of the high risks involved. The valve enters through the femoral artery in the groin area, and it is not until one reaches old age that the artery is stiff enough to manipulate without serious consequences.

Gates Vascular Institute is one of 70 hospitals in the country that is able to perform this procedure due to their brand-new facility. After opening on March 28, the institute has been designed as apremier destination for stroke care, cardiac surgery, and vascular services with the ability to house around 600 patients. This groundbreaking facility marked a new era for health care delivery in Western New York, according to a statement from James R. Kaskie, the president and CEO of Kaleida Health's website.

In the future, Hansen hopes that this will be available to a multitude of patients as a safer alternative to open heart surgery. In order for that to happen, the procedure would need to get FDA approved once again. Hansen believed this is a possibility. Currently, clinical trials are being done in Europe and, according to Hansen, doctors are working together across the world to further develop the procedure's capabilities.

Hansen and her colleagues' ultimate goal is to move away from the open-heart surgery completely. The new technologies and developments that are becoming available will soon make it possible for this procedure to become available to patients of all ages, according to Hansen.

"It's the wave of the future with technology," Hansen said. "I love my patients and I like the new technology that comes in. There is always a new procedure or something, and it's a whole new thing. I would be amiss not to mention the amazing doctors that also take part in the procedure."

Hansen reflects on the path that has gotten her to where she is in her life and encourages other students to go after what they have a passion for. She encourages students to pursue whatever they want, no matter how discouraging other people might be.

Her advice for students hoping to break into the medical field is for them to try out many different departments before deciding on a department to work in.

"If they have an idea of what they want to do in medicine, they should follow it," Hansen said. "They should find the opportunities to expose themselves to as much as possible. Go with what interests them."

Hansen encourages anyone who knows someone suffering from aortic stenosis to contact Gates Vascular Institute to see if the patient could be eligible for a TAVR procedure.