Phoebe Performs Region's First Valve-in-Valve Replacements

Staff Report

Thursday, January 5th, 2023

The Phoebe Heart & Vascular team continues its long history of bringing groundbreaking cardiology treatments to south Georgia. Phoebe’s experts recently completed two advanced valve-in-valve replacements, marking the first time both procedures had been performed in the region.

“For decades at Phoebe, we have been committed to providing cutting-edge procedures to the people of southwest Georgia, giving them the chance to receive lifesaving and life-improving cardiology care close to home,” said Mark Cohen, MD, Phoebe’s Medical Director of Cardiology. “We have the largest, best-trained and most-experienced heart and vascular team in south Georgia, and we are the only place in our region that provides many advanced cardiology treatments.”

Phoebe currently performs nearly 100 different cardiology procedures and was the first hospital in south Georgia to offer nearly all of them. Since 2017, Phoebe has performed more than 170 transcatheter aortic valve replacements (TAVR) which restore blood flow and reduce symptoms such as chest pain, shortness of breath, fainting and fatigue – all without requiring open-heart surgery. In October, Phoebe Interventional and Structural Cardiologist Dr. Tharmathai Ramanan led a team that replaced a patient’s TAVR valve by actually placing a new valve inside the old one.

“We know that valves will degenerate at some point, so being able to provide a minimally-invasive replacement option helps patients avoid open-heart surgery,” Dr. Ramanan said. “We do it the same way as the initial valve replacement, but it’s a more intricate and high-risk procedure, so even some hospitals that perform TAVRs do not offer this kind of valve-in-valve replacement,” she added.

In early December, Dr. Ramanan and Dr. Cohen also led a team that used a catheter procedure to replace a mitral valve that had been surgically implanted in a patient 11 years ago. Because of scarring from the original surgery and some other health problems, the patient was not a good candidate for a surgical repair. “This is something that’s not done in a lot places. Most hospitals that do this procedure are academic centers involved in clinical trials that are located in larger metropolitan areas,” Dr. Ramanan said.

Dr. Ramanan completed three fellowships – in general cardiology, interventional cardiology and advanced interventional/structural cardiology – in New York before joining the growing team at Phoebe Cardiology. She gained experience in TAVR and mitral valve-in-valve replacements during her fellowship training and is excited to bring more of these advanced treatments to south Georgia.

“I definitely find it gratifying to use these procedures that I got training on. It just makes sense, as we continue to expand Phoebe Cardiology, that we provide more procedures that are high-risk and that patients may typically have to travel to Atlanta to receive,” she said.

Both the TAVR and mitral valve replacement patients are doing extremely well following their procedures.