New Cardiac Procedures Come to Naples
NCH Heart Institute unveils Structural Heart Program
Sometimes, the best just keeps getting better. The NCH Heart Institute—already ranked among the top 10 percent of cardiac surgical service providers nationwide—recently announced the addition of a new program that brings two new cutting-edge cardiac procedures to Collier County. The NCH Structural Heart Program, launched in fall 2017, introduces the transcatheter aortic valve replacement (TAVR), a noninvasive procedure for aortic stenosis, and the Watchman implant, used to reduce atrial fibrillation (AFib) stroke risk.
“We want to create a fully comprehensive valve center for the treatment of all cardiac valvular diseases, whether surgical or transcatheter,” explains Dr. Brian Solomon, NCH Heart Institute cardiothoracic surgeon. “We have expanded not just the amount, but also the depth of surgical procedures, which allows us to achieve that goal—offering the full spectrum of procedures with a comprehensive team of cardiologists and surgeons. Now, we can take on the most challenging and complicated cases and have excellent outcomes.”
According to Solomon, the TAVR procedure allows cardiac surgeons to treat aortic stenosis in intermediate- and high-risk patients. “It is an equivalent type of surgery for those who may not otherwise survive openheart surgery, giving them the same outcome,” he says. “Instead of a chest incision and without requiring us to stop the heart, a catheter is inserted into a groin artery.”
Solomon trained at New York University under the TAVR procedure’s developer, performing the procedure on about 400 patients. He was also involved in the initial training for FDA approval, and in FDA and private trials for the procedure when it was first introduced.
The Watchman Implant procedure, an alternative to prescription Warfarin for patients with AFib not caused by a heart valve problem, was brought to the cardiac program by Dr. Dinesh Sharma, NCH Heart Institute cardiologist, specializing in electrophysiology, who trained at Mount Sinai Hospital in New York.
Sharma says that AFib is a common cause of stroke because blood flow is sluggish. “Clots start forming in a small pouch in the upper left chamber of the heart, the appendage,” he explains. “We can implant the Watchman, which is like a plug, into that pouch to seal the appendage from the rest of the upper chamber. Recovery is six hours of bed rest, an overnight stay, then the patient is discharged.”
According to Sharma, patients are then prescribed blood thinners, and after six weeks, an echocardiogram is performed to ensure that the seal is complete. When the seal is confirmed, blood thinners are discontinued, and the patient is put on an aspirin regimen. Candidates for the Watchman implant include AFib patients at risk of stroke who cannot tolerate blood thinners such as Warfarin, Coumadin, Eliquis or Xarelto for longtime use, or who are at high risk for falls or other issues.
Patients who are under a cardiologist’s care can request an evaluation to see if they are good candidates for this procedure, says Vanessa Russino, ARNP-BC, NCH Structural Heart Program coordinator. She follows up with all program patients and says patients report excellent results and are very pleased with the Watchman implant procedure that allows them to stop using blood thinners.
Brian Solomon, M.D. Dinesh Sharma, M.D.