Treatments & Services

Physicians at the Emory Heart & Vascular Center can perform a minimally invasive treatment option for patients with severe aortic stenosis a narrowing of the aortic valve opening that affects tens of thousands of people each year. Recently, physicians at Emory recieved approval to perform transcatheter aortic valve replacement for inoperable patients, high risk patients as well as& medium risk patients.

The goal of the research is to compare this procedure, transcatheter aortic valve replacement (TAVR), with traditional, open-heart surgery or medication therapy in select patients. The TAVR procedure provides a new option for doctors to treat patients who are too ill or frail to endure the traditional surgical approach. Using TAVR, Emory interventional cardiologists and cardiothoracic surgeons place a new valve inside the heart without stopping the heart or even opening the chest. Patients can often recover more quickly from this minimally invasive approach to care.

The valve used in the innovative technique was recently approved by the FDA in large part as a result of more than 350 procedures performed by Emory’s skilled cardiovascular team during clinical trials. Emory is the first center performing this procedure in the Southeast and is one of the largest enrolling centers in the country. Emory Heart & Vascular Center is currently enrolling qualified patients into the Partner II trial which is evaluating the next generation Edwards Lifesciences valve. Patients who do not qualify to be a part of the Partner II trial can be evaluated for procedure using the FDA approved valve that was used in the first phase of the research, the Partner I trial.

Emory CT surgeon, Vinod Thourani, MD recently was one of the presenters to the FDA to show results that eventually led to the committee's aproval of the transcatheter aortic valve replacement (TAVR) procedure to be used in operable patients.  Previously, the procedure was only used in inoperable patients.

Physicians performing the TAVR procedure at the Emory Heart & Vascular Center

Interventional Cardiology
Vasilis Babaliaros, MD
Peter Block, MD

Cardiothoracic Surgery
Robert Guyton, MD
Vinod Thourani, MD

Key milestones accomplished by the Emory TAVR team
• 1st Center in the United States to implant the Transaortic SAPIEN commercial valve
• 1st in the United States to implant the Transapical Valve-in-Valve
• 1st Center in the world to implant a transcarotid AVR
• 2nd Center in the United States to implant a transfemoral valve-in-valve

For more information or to schedule an evaluation contact Vasilis Babaliaros, MD, 404-712-7667, or Vinod Thourani, MD, 404-686-2513.

Many patients with degenerative valve disease are ineligible for surgery because of their high-risk status (e.g., advanced age, multiple comorbidities or end-stage disease). For these patients, balloon valvuloplasty may be a viable alternative to open-heart surgery to reduce symptoms of the disease.

In balloon valvuloplasty, a small incision is made in the arm, groin area or chest wall and a catheter (thin, flexible tube) with a small, uninflated balloon attached to the tip is threaded through a blood vessel. Once the catheter reaches the damaged valve, the balloon is inflated to stretch the valve opening and allow more blood to flow through it. The balloon is then deflated and guided back through the vessel and removed.

The patient is generally awake during this procedure, and the recovery time is considerably shorter than with traditional surgery.

Balloon valvuloplasty can relieve the symptoms of valve disorders, but is not a permanent solution and often has to be repeated at a later date. In general, this procedure is more successful for mitral valve disorders than aortic valve disorders.

Until recently, the only course of treatment for a leaky heart valve was open-heart surgery, a major procedure that can require several months of recovery. The Emory Heart & Vascular Center Structural Heart Team, under the leadership of interventional cardiologist Peter Block, MD, FACC, has performed several minimally invasive repairs of the mitral valve at Emory University Hospital. This innovative procedure uses a catheter to attach a tiny metallic clip to a leaking mitral valve, the heart valve that separates the left upper chamber of the heart from the left lower chamber.

In mitral valve clip placement, a catheter (thin, flexible tube) is inserted through the skin in the groin area and guided through the femoral vein to deliver the clip to the affected area of the heart. Once in place, the clip is attached to the leaflets ("swinging doors") of the mitral valve. Once the clip is securely attached, the catheter is removed. The entire process is monitored using echocardiographic imaging and performed under general anesthesia. Because the procedure is minimally invasive, the recovery time is substantially shorter than with open-heart surgery, the traditional method for treating mitral valve leaks.

In the past, many people with holes in their hearts have faced a lifetime of anticoagulant therapy or even open-heart surgery in order to reduce their high risk of stroke. But now there is another option at Emory — a minimally invasive procedure that can close a variety of cardiac holes (septal defects) in about half an hour. The Emory Heart & Vascular Center was among the first programs in the nation to offer this option.

The left atrial appendage (LAA) is a small pouch in the left atrium. Patients with atrial fibrillation (abnormal heart rhythm) have a high risk of blood clots forming in the LAA. These clots can dislodge from the LAA and block blood flow to crucial parts of the body, including the brain (stroke). Oral anticoagulation medications may be used to reduce the risk of clots, but these medications are not safe or appropriate in some cases. For these patients, LAA occlusion is a viable treatment option.

In LAA occlusion, a catheter (thin, flexible tube) with an occlusion device attached to the tip is inserted into a blood vessel through a small incision in the groin area or the arm. The catheter is threaded through the vessel to the right atrium using X-ray or ultrasound imaging as guidance. Some patients have an existing hole in the wall between the left and right atrium called a patent foramen ovale (PFO), but in most cases, a small puncture hole is required to deliver the device to the left atrium. Once inserted into the LAA, the umbrella-like occlusion device is expanded to close off the entrance to the LAA. The puncture hole generally heals on its own following the procedure.