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Transcatheter Valve Program


Welcome

Thank you for choosing the Transcatheter Heart Program at WMCHealth Physicians. Based at Westchester Medical Center, we are the Hudson Valley's leading heart and vascular diagnosis and treatment center for northern New York City and Westchester County. We are a highly trained and experienced team in the minimally invasive management of cardiac valve disease and aortic disease.

We are the first facility in the region to offer transcatheter aortic valve replacement (TAVR) for severe aortic stenosis, and the only facility in the region offering transcatheter mitral valve repair (TMVR) for moderate to severe mitral regurgitation. Our team of cardiac specialists is here to provide you with compassionate and exceptional cardiovascular care.

Your Heart Team

From your first consultation through your follow-up care you will have a team of highly skilled and experienced cardiovascular specialists caring for you. Your heart team consists of cardiac surgeons, interventional cardiologists, electrophysiologists and cardiac imaging specialists. Members of the team are experts in the field who routinely speak around the world about minimally invasive valve techniques. Our team has particular expertise in treating very high risk patients. Members of our team lecture around the country and world about novel techniques we have developed to safely perform valve procedures in patients with advanced heart failure and advanced kidney disease. As part of your consultation the entire team meets and discusses your specific history, tests, studies and ultimately creates a management plan that the Team believes will be safe and effective at managing your particular issue.

For additional information please call 914.493.8793


Minimally Invasive Aortic Valve Replacement with TAVR

There are currently two treatment options for severe aortic stenosis. The first option involves the replacement of the valve by open heart surgery, a procedure called surgical aortic valve replacement (SAVR). The second option involves replacing the aortic valve using a catheter, avoiding open heart surgery. This procedure is often abbreviated TAVR (Transcatheter Aortic Valve Replacement) or TAVI (Transcatheter Aortic Valve Implantation).

Westchester Medical Center is proud to be the only hospital to offer this service in Westchester County, the Greater Hudson Valley, and Fairfield County, CT. This procedure is performed in the Medical Center's state-of-the-art hybrid operating room.

How TAVR is Performed at Westchester Medical Center

TAVR is most commonly performed through an incision in the groin that is less than one-inch long. In the rare case that it is not possible to perform the procedure through the groin, alternative access via the arrm, neck or upper chest may be used. Our thorough preoperative evaluation will determine which is the best and safest approach for each patient. Most procedures are performed under sedation, which maximizes patient comfort and speeds up recovery by avoiding general anesthesia. The procedure itself typically takes less than two hours and the typical hospital stay is one to two nights.

Westchester Medical Center’s TAVR expertise is broad-based:

  • It has the lowest in-hospital/30-day risk-adjusted mortality rate, 2.97 percent, in New York State, according to the New York State Department of Health. (Data, published in February 2018 in Percutaneous Coronary Interventions (PCI) in New York State, are for centers performing more than 50 procedures per year.)
  • More than 650 TAVR procedures have been performed.
  • The median length of hospital stay is under 72 hours.
  • Westchester Medical Center’s novel low-contrast techniques enable care for patients with severe chronic kidney disease.
  • The team has vast experience treating patients with complex vascular access.
  • TAVR procedures are performed in a state-of-the-art hybrid operating room. The 1,000-square-foot suite combines the traditional operating room with the advanced-imaging capabilities of a modern cardiac catheterization laboratory. This innovative environment provides precision and a comfortable, reassuring setting for patients.

Frequently Asked Questions

Select a topic below to learn more:

About Aortic Stenosis

What is aortic stenosis?

Aortic stenosis is the most common problem of the aortic valve. The aortic valve is the last valve in the heart before all the blood in the heart is pumped to the body. “Stenosis” means narrowing. Thus, with aortic stenosis the aortic valve becomes narrow, forcing the heart to pump blood to the body through a very small opening. This can cause a number of problems and symptoms including shortness of breath, fatigue, chest pain or dizziness. Without treatment aortic stenosis will cause heart failure and ultimately death. There are no medicines or lifestyle changes that can effectively treat aortic stenosis. The only effective treatment is valve replacement.

What are the symptoms of aortic stenosis?

Aortic stenosis develops very gradually over the course of many years. As a result, the body does a good job of compensating for the progressive narrowing of the valves. Thus, patients with aortic stenosis often have no symptoms until the valve becomes extremely narrowed. Symptoms include chest discomfort (angina), light-headedness, fainting (syncope), shortness of breath, fatigue or heart failure. Because the aortic stenosis develops slowly the symptoms can be very subtle at first, causing many patients to say, ”I am fatigued or short of breath because I am old or out of shape.” If you experience these symptoms and signs you should consult your doctor urgently to determine the severity of your condition.

How is aortic stenosis diagnosed?

An echocardiogram is a simple test that uses ultrasound waves to look at the heart and the valves to assess whether or not someone might have aortic stenosis. The area of the aortic valve can be measured during an echocardiogram to determine the degree of aortic stenosis someone might have. It is usually classified as mild, moderate or severe. This procedure is usually done in a physician’s office or imaging office.

Aortic stenosis can also be diagnosed by performing a cardiac catheterization. This procedure is performed in a hospital by an interventional cardiologist. Small catheters are placed through the artery in the leg and threaded up to the heart to measure the degree of narrowing of the aortic valve.

What is the current treatment of severe aortic stenosis?

If your aortic valve is severely narrowed, your doctor will discuss options with you. There are no medications that can halt or slow down the progression of aortic stenosis. If you do not have symptoms with good heart function, then close observation may be adequate. However, your doctor may perform a stress test which can often elicit hidden symptoms, such as fatigue. If you have symptoms, you need an urgent consultation with your doctor.

What if I don’t want anything done for my aortic stenosis?

There is no medical treatment for aortic stenosis. If you have mild or moderate aortic stenosis you can follow up with your doctor and he or she will advise you what to do. However, if you have severe aortic stenosis and symptoms, you need to seek urgent medical attention. In cases where individuals cannot undergo surgery or TAVR, balloon aortic valvuloplasty (BAV) may be another option.

 Transcatheter Aortic Valve Replacement (TAVR) Effectiveness and Benefits How effective is TAVR/TAVI?

Studies have shown that TAVR is as effective as or even superior to surgical AVR in moderate to high risk patients and is better than medication in prohibitive risk patients who are considered too high risk for open heart surgery. In 2019, the FDA updated guidelines to indicate that TAVR is also appropriate for patients with severe aortic valve stenosis at low surgical risk.

How will TAVR benefit residents of the Lower Hudson Valley region?

Prior to Westchester Medical Center's new Transcatheter Heart Program, this treatment was not available in Westchester County and the Hudson Valley. Patients no longer have to worry about traveling to New York City to have the TAVR procedure done. Being closer to home will make scheduling appointments easier and your follow-up with your cardiac surgeon and cardiology team will be much more convenient.

How many TAVR/TAVI have now been done?

The first TAVR was performed in 2002 in Europe and in 2006 in the US. Since then, >200,000 TAVR procedures have been done around the world and >30,000 in the US.

Will I be awake for the procedure?

TAVR can be done under general anesthesia or local anesthesia with IV sedation. We have found patients who had local anesthesia recover faster and go home more quickly. Our team including anesthesiologists will discuss and recommend the best option for you.

I have other medical issues in addition to aortic stenosis, how will that affect whether or not I am eligible for the procedure?

Our Transcatheter Heart Program team includes multidisciplinary specialists, such as internists, endocrinologists, neurologists, renal (kidney) specialists, nutritionists and social workers who work together with our cardiologists and cardiothoracic surgeons. Together our team will assess your medical history and existing health condition to determine your eligibility for the TAVR procedure. A part of our comprehensive approach to your care includes the involvement of medical specialists who collaborate to ensure a treatment plan specific to your needs and current health. Our team will, for example, consider existing conditions such as diabetes, liver or kidney problems, and any other existing health problems you might have--in addition to aortic stenosis when planning your treatment course. Westchester Medical Center is also highly ranked both nationally and regionally for heart care and cardiac surgery.

What is the age limit to be a candidate for TAVR?

There is no age limit for TAVR. The majority of TAVR patients are in their late 70’s to 100s.

How long does the transcatheter valve last in TAVR?

Studies have shown the valves to be durable over 5 years with some data suggesting over 10 years. Rarely patients have returned for a repeat procedure due to transcatheter valve failure. Even so, there are now minimally invasive and catheter options to address a failing transcatheter valve.

What is the difference between the Edwards Sapien XT and Medtronic CoreValve?

The Edwards Sapien XT, a balloon-expandable valve available in three sizes, is deployed by inflating a balloon to anchor the new valve against your own aortic valve. The Medtronic CoreValve, a self-expanding valve available in four sizes, is deployed by unwinding a catheter to release the new valve against your own aortic valve. There is no difference in performance between the two heart valves, based on numerous clinical studies and after 200,000 implants worldwide.

How do I choose between the Edwards Sapien XT and Medtronic CoreValve?

The Transcatheter Heart Program team at Westchester Medical Center will recommend the best valve option for you based on several factors, including your medical condition and your aortic valve anatomy. Both heart valves are approved by the FDA for use in TAVR.

Transcatheter Valve-in-Ring and Valve-in-Valve Replacement Procedures

I have previous aortic valve replacement and now have a failing prosthetic aortic valve. Am I eligible for TAVR/TAVI?

Our multidisciplinary heart team will evaluate the mechanism of your failing prosthetic aortic valve. Patients with a failing mechanical valve will not be a TAVR candidate. Those with a tissue aortic valve may be eligible for the TAVR, if the valve and heart anatomy are suitable. The procedure is called an aortic valve-in-valve (AVIV) replacement procedure. Currently, the Medtronic CoreValve is approved by the FDA for such a procedure.

What is a transcatheter aortic valve-in-valve replacement procedure?

Patients with a failing tissue prosthetic valve after previous aortic valve replacement, who are considered high or extreme risk for repeat open surgery to fix the prosthetic valve, may be considered for an aortic valve-in-valve replacement procedure. With suitable anatomy, the failing prosthetic aortic valve can be replaced without open heart surgery, minimally invasively in a beating heart. The procedure is very similar to TAVR, can be approached via the leg artery at the groin (transfemoral), the left shoulder (transaxillary) or the chest through the aorta (transaortic) or the apex of the heart (transapical). The transcatheter aortic valve-in-valve replacement, if done transfemorally, may be performed with only local anesthesia and IV sedation, maximizing patient recovery while minimizing hospital stay. Our Heart Team will carefully evaluate your history, tests and anatomy to determine if you will be a candidate for such a procedure.

I have previous mitral valve repair with open heart surgery and now have mitral regurgitation. Am I eligible for TAVR?

TAVR is indicated in patients with severe aortic stenosis. Our multidisciplinary heart team will evaluate the mechanism of the mitral regurgitation. Patients with prior mitral valve repair with open heart surgery may be eligible for the MitraClip transcatheter mitral valve repair procedure to re-repair the valve, if the valve and heart anatomy are suitable. Alternatively, they may be considered for a transcatheter mitral valve-in-ring (TMVIR) replacement procedure, performed minimally invasively without open heart surgery.

I have previous mitral valve replacement with open heart surgery and now have mitral stenosis or regurgitation in my prosthetic valve. Am I eligible for TAVR?

TAVR is indicated in patients with severe aortic stenosis. Those with prior mitral valve replacement may be considered for a transcatheter mitral valve-in-valve (TMVIV) replacement procedure, which is a minimally invasive way to replace a diseased prosthetic mitral valve without open heart surgery. Patients with a failing mechanical mitral valve will not be a candidate. Our team will evaluate the mechanism of your prosthetic mitral valve failure, your valve and heart anatomy to determine if you will be a candidate.

What is a transcatheter mitral valve-in-ring or valve-in-valve replacement procedure?

Patients with a failing mitral valve after mitral valve repair or replacement, who are considered high or extreme risk for repeat open surgery to fix the mitral valve, may be considered for one of these procedures when no alternative treatments are available. With suitable anatomy, a failing mitral valve after surgical repair with a ring that cannot be fixed with a MitraClip can be replaced by a transcatheter heart valve, e.g. the Edwards Sapien XT valve. This is called a transcatheter mitral valve-in-ring replacement. Similarly, a failing prosthetic tissue mitral valve can be replaced by a transcatheter heart valve, in a procedure called transcatheter mitral valve-in-valve replacement.

Both procedures can be approached via the groin vein, the leg vein (transfemoral) or the chest through the apex of the heart (transapical). Our Heart Team will carefully evaluate your history, study images and anatomy to determine if you will be a candidate for one of these procedures. Westchester Medical Center is one of few programs in the country that offers this innovative therapy to our patients who are considered high risk or too sick for repeat open heart surgery.

I have previous tricuspid valve repair with open heart surgery and now have tricuspid regurgitation. Am I eligible for TAVR?

TAVR is indicated in patients with severe aortic stenosis. Our multidisciplinary heart team will evaluate the mechanism of the tricuspid regurgitation. Patients with prior tricuspid valve repair with open heart surgery may be eligible for a minimally invasive transcatheter tricuspid valve-in-ring replacement (TTVIR) procedure, if the valve and heart anatomy are suitable. This procedure can be done via the leg vein (transfemoral) on a beating heart without open heart surgery.

I have previous tricuspid valve replacement with open heart surgery and now have tricuspid stenosis or regurgitation. Am I eligible for TAVR?

TAVR is indicated in patients with severe aortic stenosis. Patients with a failing tricuspid valve from prior tricuspid valve replacement may be considered for a transcatheter tricuspid valve-in-valve (TTVIV) replacement procedure, which is a minimally invasive way to replace a diseased prosthetic tricuspid valve without open heart surgery. This procedure can be done via the leg vein (transfemoral) on a beating heart. Westchester Medical Center is one of few programs in the country that offers this innovative therapy to our patients who are considered high risk or too sick for repeat open heart surgery.

The TAVR Process at Westchester Medical Center

What kind of tests or pre-testing will I need to go through to be considered for TAVR?

To be considered for TAVR, you will visit us at our Transcatheter Heart Program location in Westchester, NY where our cardiology team will assess your current health condition and medical history and determine if you are an ideal candidate for the TAVR procedure. After that, you will undergo a series of lab and imaging tests.

I have been told I have kidney issues, how will that affect my ability to have the CT scan for TAVR evaluation?

We offer consultation with our nephrologist during your clinic visit, or we consult with your internist or nephrologist to review your kidney condition and your ability to undergo a cardiac CT and CT with contrast of the chest, abdomen and pelvis. There are several options to prepare you for the CT study. Alternatively, transesophageal echo is another imaging study that can evaluate your aortic valve anatomy. Our team of interventional cardiologists, echo cardiologists, cardiac surgeons and cardiac radiologists work closely together to provide the imaging study you need for TAVR evaluation.

How long does the TAVR/TAVI procedure take?

The TAVR procedure itself takes approximately 2 hours, but will require additional time to get you prepared; placement of monitoring lines, anesthetic induction and room setup.

Will I be able to go home on the same day after the procedure?

You will not go home on the same day of the transcatheter aortic valve replacement procedure. You might however, be admitted to the hospital the day before the procedure.

How long is the hospital stay?

The hospital stay, on average, is approximately 2-7 days. However, some patients might recover more quickly and might be eligible for discharge in 1-3 days.

If I’m selected for the procedure, how will I know if my health insurance will cover TAVR?

Our billing specialists will work with the Transcatheter Heart Program team to determine your insurance coverage for the procedure.

Will I feel better after the TAVR procedure?

A majority of patients without lung and other existing heart problems can expect improvement of their symptoms, reduced chest discomfort, as well as a reduction in feelings of light-headedness and shortness of breath.

How long will the recovery process be after the TAVR procedure?

After discharge from the hospital, it takes on average 2-3 weeks to fully recover from TAVR. Our patients are expected to be able to walk about unassisted 1 - 2 days after the procedure. Some patients will be eligible to return home following the procedure and the required hospital stay. Other patients might benefit from additional rehabilitation services after the procedure either as an inpatient or outpatient. Our team of social workers at the Transcatheter Heart Program will work closely with you and your family to determine the best course for you.

What kind of follow-up will I need?

TAVR patients will participate in a comprehensive follow-up program to ensure full-recovery and an improved quality of life. A component of the follow-up program will be incorporated into the national Transcatheter Valvular Therapy (TVT) database. Your first follow-up visit with us after the TAVR procedure will be 4 weeks, then 6 months and 12 months, or earlier if necessary.

Can I request the TAVR procedure even if I’m a candidate for traditional open chest surgery but not high risk?

TAVR is now approved for patients with low and moderate risk for open surgery. You or your doctor may request an evaluation for the TAVR procedure. The TAVR team will determine which procedure is best for you.

I notice that a couple other hospitals in the region provide the procedure, what sets Westchester Medical Center's Transcatheter Heart Program apart?

Three things set us apart from other TAVR programs: excellence, accessibility, and convenience.

EXCELLENCE: Westchester Heart & Vascular's TAVR program has been built on Westchester Medical Center's reputable cardiology program. Our cardiothoracic surgery team has delivered exceptional outcomes for surgical aortic valve replacement (AVR) including in high risk patients. Our interventional cardiologists have also achieved high success rates in their specialties. Our cardiothoracic surgeons and interventional cardiologists have trained in transcatheter aortic valve replacement procedures at leading institutions, have a long history working together and will bring their expertise to this innovative therapy with the ultimate objective of improving our patients' quality of life.

ACCESSIBILITY: Our optimal location in Westchester County and regional proximity to your home will positively impact the quality and effectiveness of this treatment option. This means shorter travel distances for patients and their families when they need to make office visits, come in for the procedure and follow-up. This significantly reduces the length of time you will wait to receive care.

CONVENIENCE: Our Transcatheter Heart Program location is a model of efficiency. Patients can have all their required preliminary testing completed in one location, very often on the same day. Free on-site parking, including free valet parking, is also available to our patients and their families. The Medical Center is pleased to be among a select few hospitals to offer TAVR in New York.

 


Minimally Invasive Treatment of Mitral Valve Disease, Transcatheter Mitral Valve Repair (TMVR), the MitraClip Procedure, Conveniently Located for Residents of New York

Make a selection below for more information.

Minimally Invasive Mitral Valve Repair with MitraClip Procedure

There are currently two treatment options for severe mitral regurgitation. The first option involves repairing or replacing the valve by open heart surgery, a procedure called mitral valve repair or replacement (MVR). The second option involves repairing the mitral valve using a catheter, avoiding open heart surgery. This procedure is often abbreviated TMVR which stands for Transcatheter Mitral Valve Repair, using a device called the MitraClip. The TMVR procedure is also known as the MitraClip procedure, or “Butterfly” repair procedure.

Westchester Medical Center is proud to be one of a few hospitals to offer TMVR in New York and the only one in Westchester County, Bronx and the greater Hudson Valley and Fairfield County, CT to offer this service. The Medical Center's heart specialists will perform transcatheter mitral valve repair (TMVR) using the Abbott MitraClip, FDA-approved for the treatment of moderate to severe mitral regurgitation. This procedure will be performed in the Medical Center's new hybrid operating room.

In September 2018, results of a COAPT trial showed that this procedure reduced all-cause mortality by nearly 40 percent for patients with secondary regurgitation due to heart failure.

At Westchester Medical Center, 40 percent of patients are discharged the day after the procedure. In addition, 30 days after the procedure, patients have 85 percent freedom from moderate to severe mitral regurgitation. The first MitraClip transcatheter mitral valve repair procedure done in the Hudson Valley was performed at Westchester Medical Center.

How TMVR MitraClip Procedure is Performed at Westchester Medical Center

The TMVR procedure with MitraClip is performed from the groin via your leg vein (transfemoral). It is guided by a high-resolution X-ray machine (fluoroscopy) and real-time 3D ultrasound images of the heart called transesophageal echo (TEE).

Transcatheter Heart Program TMVR Physician Referral and Patient Self-Referral

Transcatheter mitral valve repair with the MitraClip is the latest and one of the most innovative procedures to treat mitral regurgitation. The Transcatheter Heart Program at Westchester Medical Center is this region's only program providing this service, delivered by the capable heart and vascular specialists at Westchester Heart & Vascular Institute. Referring physicians are encouraged to complete a referring form on their patients' behalf. Patients can also self-refer themselves to be considered for a consultation.

MitraClip Transcatheter Mitral Valve Repair (TMVR) Effectiveness and Benefits

Am I an ideal candidate for TMVR?

The MitraClip procedure is a new treatment alternative to surgical mitral valve repair (MVR) for patients who have symptoms from moderate to severe mitral regurgitation, but are considered prohibitive risk or high risk to undergo open heart surgery. Our team uses an established checklist and other factors to determine if you will be eligible for TMVR. If you or someone you know of has a known heart murmur, consult a physician for a possible diagnosis of mitral regurgitation and see if you may be eligible for the MitraClip TMVR procedure.

How effective is TMVR?

Studies have shown that TMVR is as safe as surgical mitral valve repair and better than medication alone in high or prohibitive risk patients who are considered too high risk for open heart surgery. The MitraClip procedure is effective in improving the severity of your mitral regurgitation, your symptoms and quality of life.

How will TMVR benefit residents of the Lower Hudson Valley region?

Prior to Westchester Medical Center's new Transcatheter Heart Program, this treatment was not available in Westchester County and the Hudson Valley. Patients no longer have to worry about traveling to New York City to have the MitraClip procedure done. Being closer to home will make scheduling appointments easier and your follow-up with your cardiac surgeon and cardiology team will be much more convenient.

Will I be awake for the procedure?

Currently, TMVR with MitraClip is done under general anesthesia. Our team including anesthesiologists will discuss any anesthesia concerns with you.

I have other medical issues in addition to mitral regurgitation, how will that affect whether or not I am eligible for the procedure?

Our Transcatheter Heart Program team includes multidisciplinary specialists, such as internists, endocrinologists, neurologists, renal (kidney) specialists, nutritionists and social workers who work together with our cardiologists and cardiothoracic surgeons. Together our team will assess your medical history and existing health condition to determine your eligibility for the TMVR procedure. A part of our comprehensive approach to your care includes the involvement of medical specialists who collaborate to ensure a treatment plan specific to your needs and current health. Our team will, for example, consider existing conditions such as diabetes, liver or kidney problems, and any other existing health problems you might have--in addition to mitral regurgitation when planning your treatment course. Westchester Medical Center is also highly ranked both nationally and regionally for heart care and cardiac surgery.

What is the age limit to be a candidate for TMVR?

There is no age limit for TMVR. The majority of TMVR patients are in their 70’s to 100’s.

What is the MitraClip device made of and how does it reduce mitral regurgitation?

The MitraClip device is a small metal clip about the size of a dime, covered with a polyester fabric that is implanted on your mitral valve. The clip is inserted through a catheter, without the need to temporarily stop your heart. The MitraClip device treats mitral regurgitation by clipping together a small area of the mitral valve that was causing the leak. The valve continues to open and close on either side of the clip. This allows blood to flow on both sides of the clip while reducing the flow of blood backward towards the lungs.

Transcatheter Mitral Valve-in-Ring and Mitral Valve-in-Valve Replacement Procedures

I have previous mitral valve repair with open heart surgery and now have mitral regurgitation. Am I eligible for the MitraClip procedure?

Our multidisciplinary heart team will evaluate the mechanism of the mitral regurgitation. Patients with prior mitral valve repair with open heart surgery may be eligible for the MitraClip procedure, if the valve and heart anatomy are suitable. Alternatively, they may be considered for a transcatheter mitral valve-in-ring (TMVIR) replacement procedure, performed minimally invasively without open heart surgery.

I have previous mitral valve replacement with open heart surgery and now have mitral stenosis or regurgitation. Am I eligible for the MitraClip procedure?

Patients with prior mitral valve replacement are not eligible for the MitraClip procedure. However, they may be considered for a transcatheter mitral valve-in-valve (TMVIV) replacement procedure, which is a minimally invasive way to replace a diseased prosthetic mitral valve without open heart surgery.

What is a transcatheter mitral valve-in-ring or valve-in-valve replacement procedure?

Patients with a failing mitral valve after mitral valve repair or replacement, who are considered high or extreme risk for repeat open surgery to fix the mitral valve, may be considered for one of these procedures when no alternative treatments are available. With suitable anatomy, a failing mitral valve after surgical repair with a ring that cannot be fixed with a MitraClip can be replaced by a transcatheter heart valve, e.g. the Edwards Sapien XT valve. This is called a transcatheter mitral valve-in-ring replacement. Similarly, a failing prosthetic mitral valve can be replaced by a transcatheter heart valve, in a procedure called transcatheter mitral valve-in-valve replacement. Both procedures can be approached via the groin vein, the leg vein (transfemoral) or the chest through the apex of the heart (transapical). Our Heart Team will carefully evaluate your history, study images and anatomy to determine if you will be a candidate for one of these procedures. Westchester Medical Center is one of few programs in the country that offers this innovative therapy to our patients who are considered high risk or too sick for repeat open heart surgery.

The TMVR Process at Westchester Medical Center

What kind of tests or pre-testing will I need to go through to be considered for TMVR?

To be considered for TMVR, you will visit us at our Transcatheter Heart Program location in Westchester, NY where our cardiology team will assess your current health condition and medical history and determine if you are an ideal candidate for the MitraClip procedure. After that, you will undergo a series of lab and imaging tests.

I have been told I have kidney issues, how will that affect my ability to have the CT scan for TMVR evaluation?

We offer consultation with our nephrologist during your clinic visit, or we consult with your internist or nephrologist to review your kidney condition and your ability to undergo a cardiac CT and CT with contrast of the chest, abdomen and pelvis. There are several options to prepare you for the CT study. Alternatively, we can perform a non-contrast CT to evaluate your body anatomy. Our team of interventional cardiologists, echo cardiologists, cardiac surgeons and cardiac radiologists work closely together to provide the imaging study you need for TMVR evaluation.

How long does the MitraClip procedure take?

The Mitraclip procedure itself takes approximately 2-3 hours, but will require additional time to get you prepared; placement of monitoring lines, anesthetic induction and room setup.

Will I be able to feel the MitraClip implant in my heart?

No, you will not be able to feel the implant.

Will I be able to go home on the same day after the procedure?

You will not go home on the same day of the MitraClip TMVR procedure. You might however, be admitted to the hospital the day before the procedure.

How long is the hospital stay?

The hospital stay, on average, is approximately 2-3 days. However, some patients might recover more quickly and might be eligible for discharge in 1-2 days.

If I’m selected for the procedure, how will I know if my health insurance will cover TMVR?

Our billing specialists will work with the Transcatheter Heart Program team to determine your insurance coverage for the procedure.

Will I feel better after the MitraClip procedure?

A majority of patients without lung and other existing heart problems can expect improvement of their symptoms, reduced shortness of breath or chest discomfort, soon after the procedure. While in the hospital, you will be closely monitored and your doctor will perform various tests to evaluate your heart function and the mitral valve. Most patients will not need special assistance at home following discharge from the hospital, outside of ongoing needs for any unrelated health conditions.

How long will the recovery process be after the MitraClip procedure?

After discharge from the hospital, it takes on average 2-3 weeks to fully recover from TMVR. Our patients usually experience an improvement in their symptoms following immediate reduction of their mitral regurgitation. They are expected to be able to walk about unassisted 1-2 days after the procedure. Some patients will be eligible to return home following the procedure and the required hospital stay. Other patients might benefit from additional rehabilitation services after the procedure either as an inpatient or outpatient. Our team of social workers at the Transcatheter Heart Program will work closely with you and your family to determine the best course for you.

What kind of follow-up will I need?

TMVR patients will participate in a comprehensive follow-up program to ensure full-recovery and an improved quality of life. A component of the follow-up program will be incorporated into the national Transcatheter Valvular Therapy (TVT) database. Your first follow-up visit with us after the TMVR procedure will be 4 weeks, then 6 months and 12 months, or earlier if necessary.

Can I request the MitraClip TMVR procedure even if I’m a candidate for traditional open chest surgery but not high risk?

You or your doctor may request an evaluation for the TMVR procedure. Our TMVR team will determine which procedure is best for you.

I notice that a couple other hospitals in the region provide the procedure, what sets Westchester Medical Center's Transcatheter Heart Program apart?

Three things set us apart from other TMVR programs: excellence, accessibility, and convenience.

EXCELLENCE: Westchester Heart & Vascular's TMVR program has been built on Westchester Medical Center's reputable cardiology program. Our cardiothoracic surgery team has delivered exceptional outcomes for surgical mitral valve repair and replacement (MVR) including in high risk patients. Our interventional cardiologists have also achieved high success rates in their specialties. Our cardiothoracic surgeons and interventional cardiologists have trained in TMVR procedures at leading institutions, have a long history working together and will bring their expertise to this innovative therapy with the ultimate objective of improving our patients' quality of life.

ACCESSIBILITY: Our optimal location in Westchester County and regional proximity to your home will positively impact the quality and effectiveness of this treatment option. This means shorter travel distances for patients and their families when they need to make office visits, come in for the procedure and follow-up. This significantly reduces the length of time you will wait to receive care.

CONVENIENCE: Our Transcatheter Heart Program location is a model of efficiency. Patients can have all their required preliminary testing completed in one location, very often on the same day. Free on-site parking, including free valet parking, is also available to our patients and their families. The Medical Center is pleased to be among a select few hospitals to offer TMVR in New York.


Contact Us

For additional information please call 914.493.8793.  

Our Address

Westchester Medical Center
Ambulatory Care Pavilion
100 Woods Road
Valhalla, NY 10595

Directions

By Car

By Train

Westchester Medical Center is served by Metro North's Harlem line via two stations:

  • White Plains - Bus transfer options available
  • Hawthorne - Taxi service available

For train fare and schedule information, call 1-800-METRO-INFO or go to www.mta.info

By Bus

There are three bus lines (Westchester Bee Line) you can take to our campus.

Please call 914.813.7777 for bus routes and fares.

Campus Map

The Westchester Medical Center campus includes the Maria Fareri Children's Hospital and the Behavioral Health Center.


Locations

Westchester Medical Center is among less than 5 hospitals to offer TMVR in New York. We are located at:

Westchester Medical Center
100 Woods Road
Crossroads Lounge
Valhalla, NY 10595
Office: 914.493.6540
Cell: 914.830.1098

Satellite Clinics

Rockland County

Good Samaritan Hospital
Medical Office Building, 3rd Floor
Suffern, NY 10901
Office: 914.493.6540
Cell: 914.830.1098

Orange County

Advanced Physician Services
575 Hudson Valley Avenue
Suite 200
New Windsor, NY 12553
Office: 914.493.6540
Cell: 914.830.1098

Lansman, Steven L.
Lansman, Steven L.
Director, Cardiothoracic Surgery
Professor of Surgery
Cardiothoracic Surgery
Thoracic Surgery
Laskowski, Igor
Laskowski, Igor
Chief, Vascular Surgery
Vascular Surgery
Ahmad, Hasan A.
Ahmad, Hasan A.
Director, Interventional Transcatheter Valve Program
Director, Interventional Cardiology Fellowship Program
Cardiology
Cardiovascular Disease
Interventional Cardiology
Badami, Chirag D.
Cardiothoracic Surgery
Goldberg, Joshua Benjamin
Goldberg, Joshua Benjamin
Attending, Cardiac Surgeon
Cardiothoracic Surgery
Harburger, Joseph M.
Cardiology
Cardiovascular Disease
Non-Invasive Cardiac Imaging
Melcer, Joshua A.B.
Melcer, Joshua A.B.
Director, Outpatient Cardiology Practice
Cardiology
Cardiovascular Disease
Non-Invasive Cardiac Imaging
Passik, Cary S.
Cardiothoracic Surgery
Timmermans, Robert J.
Timmermans, Robert J.
Medical Director, Interventional Cardiology
Cardiology
Cardiovascular Disease
Interventional Cardiology

Additional Team Members

Echo Cardiology:
Angelica Poniros, RCS

Program Coordinator:
Joanne Bennett, FNP-BC

Cardiac Anesthesia:
Cheng Feng, MD
Suryanarayana Pothula, MD
Draginja Cvetkovic, MD
Sarah Smith, MD

Cardiac Radiology:
Anthony Gilet, MD
Anna Rozenshtein, MD
Amar Shah, MD

Hybrid OR Operations:
Cenap Undemir, MD

Research Coordinator:
Corazon De La Pena, MD

Administrative:
Reina Manea