News for Healthcare Professionals

Update from the Advanced Valve & Aortic Center
Low Risk TAVR Study Article Co-Authored by Ramlawi Published by New England
Journal of Medicine
Basel Ramlawi, MD, chairman of the Heart & Vascular Center and director
of the Advanced Valve & Aortic Center (AVAC) at Winchester Medical
Center, co-authored an article on a study of transcatheter aortic valve
replacement (TAVR) in low risk patients recently published by the
New England Journal of Medicine.
The article, “Transcatheter Aortic-Valve Replacement with a Self-Expanding
Valve in Low-Risk Patients,” was published March 16, 2019, at NEJM.org.
The study was presented at the American College of Cardiology annual meeting
in mid-March. Dr. Ramlawi presented subsequent related data at the American
Association for Thoracic Surgery annual meeting in early May. This landmark
publication shows that TAVR, and less invasive valve therapies in properly
selected patients, is benefiting patients across all risk profiles with
less pain, quicker recovery and improved clinical outcomes!
Valley Health’s AVAC was a leading study site among 64 institutions
in the country participating in the Medtronic Evolut™ Low Risk Trial.
The trial assessed the safety and efficacy of TAVR in patients with severe
aortic stenosis who are at low risk for open-heart surgical aortic valve
replacement. Initial enrollment in the trial is complete, but continued
access is ongoing.
Low Risk Bicuspid Valve Study
Valley Health is also participating in Medtronic's TAVR Low Risk Bicuspid
Valve Study, which Dr. Ramlawi is leading as the national co-Principal
Investigator. He presented on the use of TAVR to treat severe aortic stenosis
in patients with bicuspid aortic valve anatomy at the online Structural
Heart Global Grand Rounds on April 9.
Mitral Valve Program
The AVAC team has completed initial procedures for the APOLLO transcatheter
mitral valve replacement trial and the Neochord mitral valve repair trial.
Valley Health’s mitral valve program includes complex surgical repair
as well as the catheter-based MitraClip device. AVAC team members Dr.
Ramlawi, Jeffrey Skiles, MD (echocardiography), AVAC Coordinator Debra
Myers, DNP, Omar Ali, MD (interventional cardiology and AVAC co-director)
and Claudia Viens, MD (cardiac anesthesia) authored an article on transcatheter
mitral valve repair published in the
Annuals of Cardiothoracic Surgery in November.
Reference:
Ramlawi B, Skiles J, Myers D, Ali O, Viens C. Transcatheter mitral repair:
MitraClip technique. Ann Cardiothorac Surg 2018;7(6):824-826. doi: 10.21037/acs.2018.10.14
Preventive Cardiology Clinic
- Services for patients who may be at higher risk for heart disease because
of family history of coronary artery disease, personal and family history
of hyperlipidemia, genetic conditions and other factors
- Assessment, screening, education and follow-up care
- Coordination of advanced cardiac imaging such as cardiac CT, cardiac MRI
and coronary artery calcium scoring
How to Refer: Call Winchester Cardiology and Vascular Medicine | Valley Health at 540-662-0306.
Heart Rhythm Disorders
Micra® Transcatheter Pacing System
- Miniaturized leadless pacemaker for patients with bradycardia
- Provides patients with the advanced pacing technology with reduced risk
for infection or lead complications
Watchman™ Device
- Permanent heart implant to occlude the left atrial appendage through an
endovascular approach
- Reduces the risk of stroke for patients with non-valvular atrial fibrillation
and offers an alternative to the lifelong use of anticoagulation medications
such as warfarin for patients with increased bleeding risk
Hybrid Ablation
- Minimally invasive procedure that combines catheter ablation on inside
of the atrial wall with minimally invasive surgery to access outside of the heart
- Performed in Winchester Medical Center’s hybrid room by a cardiac
surgeon and an electrophysiologist
Cryoablation
- Allows the electrophysiologist to treat the whole area of heart tissue
that causes A-Fib at one time, reducing the procedure time compared to
radiofrequency ablation
How to Refer: Call Winchester Cardiology and Vascular Medicine | Valley Health at 540-662-0306.
Heart Failure
Valley Health Advanced Heart Failure & Cardiomyopathy Center
- Resources to help patients and their primary care provider or cardiologist
manage advanced heart failure and cardiomyopathy
- Outpatient evaluation and monitoring, outpatient IV infusion services and
inpatient multidisciplinary rounding, along with patient education and support
- Multidisciplinary heart failure team includes a fellowship-trained heart
failure cardiologist, an experienced cardiology nurse practitioner, nurses,
pharmacists, dietitians and other specialists
CardioMEMS™ Heart Failure System
- Measures and monitors pulmonary artery pressure and heart rate in certain
heart failure patients with the goal of reducing heart failure hospital
admissions and improving quality of life
- Small pressure-sensing device implanted directly into the pulmonary artery
during cardiac catheterization procedure
- Home electronics unit transmits the sensor’s data wirelessly to the
patient’s doctor
How to Refer: Call the Advanced Heart Failure Center at 540-536-4555.
Aortic Aneurysm near the Kidneys
Fenestrated Endovascular Aortic Aneurysm Repair
- Minimally invasive approach that allows vascular surgeons to repair an
aortic aneurysm located near or around the branch arteries to the kidneys
and other organs
- Surgeon creates holes in the stent graft called fenestrations
- Fenestrations allow blood to flow to the kidneys by the use of smaller grafts
How to Refer: Call Valley Health Vascular Surgeons at 540-536-6721.
Coronary Artery Disease
Minimally Invasive CABG
- Minimally invasive coronary artery bypass grafting through small incisions
to replace clogged arteries with a healthy vessel graft
- Procedure does not require stopping the heart, and a heart-lung machine
is not required; provides an alternative to standard open-heart bypass
surgery (CABG) when bypassing one or two coronary arteries
How to Refer: Call Valley Health Cardiothoracic Surgeons at 540-536-6721.
Carotid Artery Disease
Trans-carotid Artery Revascularization (TCAR)
- Helps reduce the risk of stroke during stenting to correct carotid artery stenosis
- Tube placed directly into the carotid artery through a smaller incision
than a typical carotid endarterectomy incision.
- Tube connected to a system that directs blood flow away from the brain
to protect against loosened plaque reaching the brain.
- System filters the blood outside the body and returns the filtered blood
through a second tube in the femoral vein.
- After stent has been placed, blood flow is resumed in its normal direction
How to Refer: Call Valley Health Vascular Surgeons at 540-536-6721.
Varicose Veins
ClariVein®OC
- Treats patients with chronic venous insufficiency and symptomatic varicose veins
- Minimally invasive/outpatient procedure
- Specialty catheter which allows the surgeon to perform non-thermal venous
ablation with no tumescent anesthesia required, resulting in a shorter
procedure time, less pain and a quicker return to normal
How to Refer: Call Valley Health Vascular Surgeons at 540-536-6721.