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Published on February 10, 2016

UHS center offers latest in heart-valve replacement

UHS is a pioneer in the use of the latest forms of aortic valve replacement and related minimally invasive procedures in heart care. Specialists at The Structural Heart and Valve Center at UHS Wilson use two types of transcatheter aortic valve replacements, often abbreviated as TAVR, to address potentially serious or life-threatening conditions experienced by many heart patients.

“We performed our first TAVR in December 2014,” said Alon Yarkoni, MD, FACC, the interventional cardiologist who serves as director of the center. “Thus far, we have completed more than 450 procedures. Our results have been extremely successful, with all major clinical metrics better than the national average, plus a marked reduction in length-of-stay.”

The procedures are performed using a catheter that accesses the heart either through a vein in the leg or through a small incision in the chest. “In the latter procedure, called the transapical approach, we insert the catheter into the chest, between the ribs, then access the aortic directly from there,” Dr. Yarkoni said. The more common method is to insert a catheter through a vein in the leg. The transapical approach is for patients who have leg arteries that are too small for a catheter. The valve team includes cardiothoracic surgeons Kenneth Wong, MD, and M. Bashar Yousuf, MD; and interventional cardiologists Hisham Kashou, MD, and Owais Ahmed, MD.

TAVR is considered a great advance in cardiac care. Using a minimally invasive approach, it enables doctors to repair a heart valve without removing the old, damaged valve, thereby avoiding conventional heart surgery. Instead, TAVR wedges a replacement valve into the original valve’s place. Somewhat similar to inserting a stent in an artery, TAVR delivers a fully collapsible replacement valve. “We are excited to offer both of the commercially available valves, including the ability to implant a new catheter valve inside a failing, old surgical valve - in a process called valve-in-valve,” Dr. Yarkoni said. “In this manner, we are able to find the best-fitting valve for each one of our patients.”