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Sorin Brener, MD, (left) director of NYM's cardiac catheterization laboratory, discusses a TAVR case with Shing-Chu Wong, MD, director of Weill Cornell's cardiac catheterization laboratory.

New York Methodist Hospital's (NYM) award-winning heart center has now added an advanced heart valve procedure for the treatment of life-threatening aortic stenosis (narrowing of one of the main valves to the heart). The procedure, transcatheter aortic valve replacement (TAVR), is performed in NYM's cutting edge cardiac catheterization laboratory by a team of experts from both NYM and NewYork Presbyterian/Weill Cornell Medical Center.

"For patients with aortic stenosis, valve replacement surgery can mean a new lease on life," explained Terrence Sacchi, MD, director of cardiology at NYM. "To replace a failing aortic valve, open heart surgery is the preferred course of action, but for some patients open heart surgery is simply not an option. They might be too sick, too elderly, unable to go on cardiopulmonary bypass, or have another condition that rules out an open procedure. Previously, the only way forward for those patients was medical management of the condition, but now, minimally invasive transcatheter aortic valve replacement offers a safe and far more effective option."

Whereas traditional valve replacement surgery requires a large incision in the patient's chest over the heart, TAVR is performed by accessing the blood vessels through a nickel sized incision in the patient's thigh. The surgical team then uses advanced, real time x-ray imaging to safely guide the prosthetic valve up the blood vessels, into the heart, and "deploy" it in the place of the old aortic valve.

Arash Salemi, MD, attending cardiothoracic surgeon and TAVR expert at Weill Cornell, views a fluoroscopic x-ray image in NYM's cardiac catheterization laboratory to safely deploy the new valve.

"Only a handful of New York City hospitals are able to offer TAVR," said Steven Silber, D.O., NYM vice president for medical affairs, who helped spearhead the establishment of NYM's TAVR program. "These procedures require a monumental amount of advanced equipment, the space to operate that equipment, and most importantly, a multidisciplinary team that works together seamlessly. To ensure that NYM immediately established itself as an elite center for transcatheter aortic valve replacement procedures, we partnered with NewYork-Presbyterian/Weill Cornell Medical Center's Department of Cardiothoracic Surgery and Division of Cardiology in 2012. By adding the skills of Cornell cardiologists to an NYM team that already included Sorin Brener, MD, director of cardiac catheterization, cardiologist Yulia Kats, MD, and cardiothoracic surgeons Iosef Gulkarov, MD, and Berhane Worku, MD, we ensured that NYM's TAVR program would hit the ground running."

"Continuing advances in technology and medical devices have ensured that cardiac surgery is a field that will evolve almost daily-to the point where staying at 'the cutting edge' might seem like an impossible task," said Anthony Tortolani, MD, NYM's director of surgery and cardiothoracic surgery.

"But that's what we always strive to do, and will continue to do, at NYM. We're thrilled to be able to offer this life-saving procedure to our community, and to all who put their trust in our Hospital for their care."