At 90, UMMC's 100th TAVR patient is 'on the go'

Published on Thursday, April 19, 2018

By: Ruth Cummins

Peggy Dudley isn’t giving up strumming the mandolin and the guitar with the Mississippi Old Time Music Society, a group she helped establish more than 20 years ago.

Try keeping her from running the cash register and educating tourists at the Old Depot Museum in Vicksburg.

Don’t even think about telling her she can’t get to services at her childhood house of worship, the Vicksburg Church of Christ.

When a heart condition threatened to take down the determined 90-year-old, she embraced a surgery at the University of Mississippi Medical Center that could restore her active lifestyle. In March, Dudley underwent a transcatheter aortic valve replacement, or TAVR, performed on patients who have aortic valve stenosis.

The procedure made personal history for Dudley, but also for the Medical Center. She’s the 100th patient to receive the surgery that corrects a form of heart disease in which the valve that regulates blood flow from the heart doesn’t fully open, causing the patient to be short of breath and fatigued. The first TAVR was performed at the Medical Center in November 2014, with numbers increasing every year. In 2017, 36 of the surgeries were performed.

TAVR “is getting to be more commonplace for older patients,” said Dudley’s physician, Dr. John Parks, assistant professor of cardiology. “This was originally a therapy designed for high-risk patients needing valve replacement, but as we get more experienced, we can branch into patients with fewer co-morbidities.”

Shreveport, La., resident Rosa Fertitta in June 2016 became UMMC’s oldest TAVR patient when she had the surgery at age 94. It gave her back her quality of life, which includes exercise and plenty of time in the kitchen baking pies and cakes.

“I feel fine,” Dudley said about a month after her procedure. “I had surgery on a Wednesday and went home on a Saturday. I’m driving again. I went down to the museum on Tuesday and worked all day.”

Dudley’s disease developed slowly. “I had a heart murmur for years, but it was nothing to be alarmed about.”

But, it caught up with the Vicksburg native in recent months. “One thing led to another, and I couldn’t breathe,” she said. “My cardiologist picked up on it and sent me to UMMC.”

She powered through her many activities until “I couldn’t do anything without getting winded,” Dudley said. She missed her duties at the museum in February, then into March.

Dudley wasn’t afraid to go under anesthesia for the minimally invasive procedure. “No hesitation,” she said. “I was ready to be able to breathe again, and I was hoping I was a candidate. And I was.”

TAVR doesn’t involve making an incision in the patient’s chest to replace the faulty valve. Instead, the heart valve team inserts a catheter about the size of a pen into the artery of a patient’s groin and carefully passes it up into the heart.

A new artificial valve is gently compressed over a balloon device at the end of the catheter. When the balloon is inflated, the new valve expands within the faulty valve, immediately improving blood circulation to the body.

It’s an attractive alternative for older patients who would be at high risk to recover from traditional open-heart surgery. UMMC physicians evaluating patients for TAVR look not just at age, but at the whole patient, including function and active lifestyle pre-surgery.

When she saw Parks April 16, a month post-surgery, Dudley made it clear she’s back to her old self and that her breathing has vastly improved. “I can get up and do what I want to,” she told Parks. “I’m sleeping in my own bed. I don’t have to sleep in the recliner.”

“Your heart function is good,” Parks told her. “Overall, I think you’re doing well. I’m glad you’re back to working, and to doing the things that you like to do.”

Other than her valve defect, Dudley is healthy and spry for her age, said Kristy Womack, RN structural heart coordinator in the adult heart valve program. “She’s a pistol,” Womack said. “Her main goal was to get back to volunteering at the museum, and to driving herself.”

Her experience at UMMC was a good one, she told Parks. “When I had my surgery, the waiting room was full of my family and my church family.

“I had fun with them on the floor,” she said of her nursing staff. “There was a whole procession of people coming into my room. I told them, ‘If many more of you come in, I’m going to start charging admission.’”

Dudley was born into a musical family. In addition to the mandolin and guitar, “I play the hammer dulcimer, the lap dulcimer and the keyboard,” she said.

She finished her education at the old Jett High School in Vicksburg. “I went straight to work at Western Union,” she said. “That was during the war, and everyone needed help.”

From there, she took a post at Magnolia Homes, then Eagle Transit Company. “When the government put in the Lower Mississippi River Museum, I worked there for a while,” Dudley said of the riverfront structure on Washington Street in Vicksburg.

Thanks to the surgery, she’s back to her full plate at church. That includes congregational singing and taking part in a ladies’ Bible class “if I’m not working that day.”

“She’s a very independent woman,” said her longtime church friend, Patsy Hammack of Vicksburg. “Up until a couple of years ago, she cut her own grass. She’s amazing.”

Dudley is glad to be rid of her cardiac diet. “I don’t have to have an omelet that looks like a piece of cardboard that someone took an iron to,” she said. “Imagine having turnip greens without any seasoning – and you can just throw that Mrs. Dash in the garbage.”

Womack and others on her UMMC heart team have a soft spot for the woman whose speech might sound a little gruff, but whose attitude is anything but. “Just because you’re 90 doesn’t mean you’re going to sit on your backside all the time,” Dudley advises.

“She is full of life at 90 years young,” Womack said. “I see myself in her.”