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Baystate Heart and Vascular Program brings breakthrough surgery to western Massachusetts

November 27, 2012

This holiday season, a cutting-edge cardiovascular procedure is giving area patients additional years of life. 


The cardiac surgeons, interventional cardiologists and supporting surgical teams of the Baystate Heart and Vascular Program have brought another advanced cardiovascular procedure to western Massachusetts, as the hospital is now performing transcatheter aortic valve replacement (TAVR) surgery, a state-of-the-art procedure for patients suffering from aortic stenosis, a debilitating gradual failure of the heart’s aortic valve that has up to 50% one-year mortality for those who experience it and who are poor candidates for surgical valve replacement.


Baystate Medical Center is one of a select group of hospitals in the nation to offer the advanced procedure, and the only Massachusetts hospital outside of Boston to perform it.


TAVR is a heart surgery in which a failing aortic valve is replaced minimally invasively via a small incision in the patient’s leg or chest wall and a catheter up into the heart itself. The procedure, similar to angioplasty, makes it possible to perform heart-valve repair for patients whose age or other health challenges would make an open heart surgery unrealistic or excessively risky.


Cardiac surgeon Dr. Joseph Flack and interventional cardiologist Dr. Ashequl Islam of the Baystate Heart and Vascular Program have led a specialized team in performing these procedures since the Baystate TAVR program got underway in July. Physicians joining Drs. Flack and Islam on Baystate’s TAVR team are: Drs. John Joelson, Daniel Engelman, Leng Jiang, Colin Shafer, Gregory Valania, Ananth Kashikar and Christopher Moore . 


Patient who successfully undergo TAVR typically experience significant improvements in their overall quality of life and level of activity, and may expect life expectancy well beyond what they would have experienced without the procedure.


In TAVR, the replacement aortic valve is carried through the femoral artery or a small incision on chest wall, with the interventional cardiologist and support team ‘driving’ the catheter up into the patient’s heart while the cardiac surgeon manages the insertion into the artery and stands ready to assist if complications occur. Using a process called ‘pacing,’ the heart’s rhythm is speeded up to a point where the flow of blood through the organ is reduced enough to allow insertion of the new valve.


Dr. Aaron Kugelmass, medical director of the Baystate Heart and Vascular Program and chief of the Division of Cardiology at Baystate Medical Center, says TAVR is a game-changer for the region: “Minimally invasive approaches to cardiac therapy such as TAVR enable us to address the cardiovascular disease of a significantly larger group of patients—people who could experience major complications from a more invasive open-heart surgery. TAVR is a transformative technology, still a relative rarity in the U.S., and we’re thrilled to be offering this extremely sophisticated procedure here in western Massachusetts.”  


In addition to making aortic-valve replacement available to a larger subset of patients—most of whom would have no other treatment option—the minimally invasive approach of TAVR means faster recovery time: a more rapid return home and resumption of normal activity. “It’s been very satisfying to see how quickly most of our TAVR patients have reported feeling better and improvement in their overall health,” says Dr. Islam. 


The advanced procedure rooms in the hospital’s new Davis Family Heart and Vascular Center were designed specifically to support a ‘hybrid’ clinical approach such as TAVR: an interventional cardiologist working side-by-side with a cardiac surgeon and multidisciplinary care team, with advanced imaging close at hand, to support the patient through every phase of the hospitalization and beyond. “Procedures such as TAVR wouldn’t have been possible without the investment in and construction of the Davis Center,” says Dr. Flack.