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Heart Valve Replacement – Without Opening the Chest


Aortic valve stenosis – a narrowing of the valve that controls blood flow from the heart – is an inevitability in older age. It cannot be prevented, and there are no drugs on the market to treat it. More and more Americans are living long enough to develop the condition, and for those too old and weak to undergo traditional open heart surgery, the outlook was once very grim. 

That is, until the arrival of the Transcatheter Aortic Valve Replacement (TAVR) procedure.

couple at table

Dominican Hospital now offers the groundbreaking TAVR procedure, which allows for heart valve replacement without opening a patient’s chest. Dominican is one of the select providers in the nation, and the only hospital in the entire Monterey Bay area, performing this procedure. 

“Previously, patients had to travel out of the community for this procedure,” said Nanette Mickiewicz, MD, Dominican Hospital president. “We’re pleased to be able to offer the most advanced heart valve replacement possible right here in Santa Cruz.”

Compared to traditional open heart surgery, TAVR is significantly less invasive, requiring only a small incision. The procedure is conducted in the hospital’s cardiac cath lab, and FDA approved for patients who are too frail or high-risk for traditional open heart surgery.

“TAVR has been a game changer for our patients who were previously too sick or too high risk for traditional surgical valve replacement,” said Neil Sawhney, MD, interventional cardiologist. “It has literally given them their lives back by taking a universally lethal condition with severe symptoms and, in the course of hours, restoring their quantity and more importantly quality of life.”

During TAVR, the surgeon attaches the replacement heart valve to a balloon and inserts the balloon into the body via catheter through the patient’s leg or chest while the patient is under general anesthesia. The new valve is positioned inside the faulty aortic valve and the balloon is inflated, precisely positioning the replacement valve. Typical recovery time is three to five days.

“TAVR is a much more simple procedure than traditional open heart surgery – for both the surgeon and the patient,” said Bilal Shafi, MD, cardiothoracic surgeon. “The catheter technology means less pain and a faster recovery.”

The procedure requires a close collaboration between a cardiac surgeon and an interventional cardiologist. Cardiothoracic surgeon Dr. Bilal Shafi and cardiologist Dr. Neil Sawhney, both from Palo Alto Medical Foundation, work side by side during each TAVR because the procedure combines surgical implantation with traditional cardiac cath lab techniques. 

The expert cardiac team at Dominican Hospital has treated some of the most complex cardiac cases in the Monterey Bay area, and the hospital has been recognized repeatedly for superior patient outcomes.