Recently, surgeons at CaroMont Regional Medical Center made history by
performing the hospital’s first Transcatheter Aortic Valve Replacement
(TAVR). The state-of-the-art surgical procedure combines the expert skill
of cardiac surgery with advanced imaging technology to replace damaged
heart valves in patients who may not be good candidates for traditional
open heart surgery. The procedure was performed by Dr. Amish Sura, a structural
interventional cardiologist, and Dr. James Greelish, CaroMont Health’s
Medical Director of Cardiac Surgery and the Cardiovascular Service Line
Physician Administrator.
“TAVR is going to be the gold standard for how we treat for patients
[who meet specific criteria] with severe, symptomatic aortic stenosis,”
said Dr. Sura. “Right now, the procedure is most appropriate for
patients who are not favorable candidates for open heart surgery, typically
due to other complicating health issues, but we expect TAVR will become
the standard approach for many more patients in the future.”
The highly-advanced procedure is used to treat aortic stenosis, which is
a narrowing of the valve of the main artery that carries blood away from
the heart to other parts of the body. Left untreated, aortic stenosis
causes significant injury to the heart and can result in heart failure
and stroke. TAVR uses a catheter, typically inserted through a small incision
in the patient’s leg, to guide a tightly collapsed prosthetic valve
into the heart under x-ray guidance. The prosthetic valve is then opened,
much like an umbrella, and the old, diseased valve is pushed aside. Once
the new valve is open, it immediately starts working. TAVR typically takes
less than two hours, which is much shorter than traditional open-heart surgery.
The TAVR program at CaroMont Regional Medical Center is a further extension
of the many services provided by CaroMont Heart & Vascular. This cutting
edge procedure relies on a highly skilled surgical team, including Dr.
Sura, Dr. Greelish and Dr. Harpreet Bhalla, an interventional cardiologist
who oversees the imaging portions of each TAVR procedure. Each week at
a multi-disciplinary conference, the team evaluates cases that may benefit
from this new, minimally-invasive technique and works closely with Cardiac
Anesthesiologists and support staff.
“CaroMont Heart & Vascular has a strong team approach to caring
for our patients,” said Dr. Greelish. “This is particularly
evident with TAVR because it requires a significant level of skill and
collaboration, not only with doctors, but with the entire surgical team.
Our level of expertise certainly places us among the top cardiovascular
teams in the state and our commitment to collaboration means we always
put our patients first.”
This surgery is exciting not only for its historic significance for the
hospital, but it was also the first procedure done in the new state-of-the-art
Hybrid Operating Room. The Hybrid OR combines a traditional operating
room and cardiac catheterization lab with advanced imaging systems.
“The hybrid operating room is an important addition to our CaroMont
Regional Medical Center surgical program,” said Dr. Bhalla. “We
as physicians and surgeons now have more tools in our arsenal when it
comes to treating complex cardiac and vascular issues. The integration
of advanced imaging equipment makes this the most advanced operating room
and surgical technology in our community.”
Dr. Sura sees the addition of the hybrid operating room and CaroMont Health’s
work to bring more minimally-invasive technology to the community as confirmation
of the health’s systems commitment to putting care first.
“The health system’s commitment to bringing advanced technology
to the medical community is very encouraging,” said Dr. Sura. “I
have always been a champion for TAVR because it can be life-changing and
life-saving for patients.”
Provider Information
Amish Sura, MD
Dr. Sura joined CaroMont Heart & Vascular in 2018. With more than nine
years of experience performing complex interventional cardiac surgeries,
he participated in the original Food and Drug Administration’s clinical
trials for TAVR. He received his medical degree from the UNC School of
Medicine and completed his interventional cardiology residency at Emory
University, where much of the early TAVR research was performed.
James Greelish, MD
Dr. Greelish joined CaroMont Heart & Vascular in 2010 from Vanderbilt
University where he was an Associate Professor of Cardiac Surgery. He
currently serves as the Medical Director of Cardiac Surgery and the Cardiovascular
Service Line Physician Administrator for CaroMont Health. He is a graduate
of the Wake Forest School of Medicine and completed his residency and
fellowship at The University of Pennsylvania and The Brigham and Women’s
Hospital at Harvard Medical School. He is board certified by the American
Board of Thoracic Surgery.
Hapreet Bhalla, MD, FACC
Dr. Bhalla has been with CaroMont Health for nearly 19 years. He earned
his medical degree from the New York University School of Medicine and
is certified in cardiovascular disease and interventional cardiology by
the American Board of Internal Medicine.