Same-Day discharge after TAVR, benefits of surgery for HOCM, TCAR for carotid stenosis and a patient story.

Same-Day Discharge After TAVR

Transcatheter aortic valve replacement (TAVR), a minimally invasive procedure for severe aortic stenosis, has traditionally involved a hospital stay for post-procedural monitoring. However, advances in technique have enabled a paradigm shift towards same-day discharge, offering an opportunity for patients to enjoy an expedited recovery in the familiar comforts of home.

Mauricio Cohen, MD, the Director of Structural Heart Interventions at Cleveland Clinic Weston Hospital, states that eligible TAVR patients who are discharged the same-day experience reduced exposure to hospital-acquired infections and enjoy a faster return to their routine activities.

Each patient is meticulously evaluated by a multidisciplinary team to ensure suitability for same-day discharge, considering additional factors such as social support and proximity to a medical center, should a problem arise. The team, part of the Cleveland Clinic Heart, Vascular & Thoracic Institute in Florida, is comprised of experienced interventional cardiologists, cardiac surgeons, anesthesiologists, and specialized nursing staff.

Read more about the Same-Day Discharge After TAVR Study.

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Experience Matters in Treatment of Hypertrophic Cardiomyopathy

Nicholas Smedira, MD, Surgical Director of the Hypertrophic Cardiomyopathy Center at Cleveland Clinic's Sydell and Arnold Miller Family Heart, Vascular & Thoracic Institute in Cleveland, Ohio and Nicolas Brozzi, MD, Surgical Director of the Acute Mechanical Circulatory Support Program at Cleveland Clinic Weston Hospital recently co-wrote an article for Cardiac Care: An Update for Physicians from the Heart, Vascular and Thoracic Institute (Spring 2024) discussing the surgical treatment of hypertrophic obstructive cardiomyopathy (HOCM).

The physicians tell us that surgery for HOCM reliably reverses disabling heart failure by permanently abolishing mechanical outflow impedance and mitral regurgitation, resulting in normalization of left ventricular pressures and preserved systolic function. In addition to improved quality of life, surgery reduces frequency of atrial arrhythmias and improves long-term survival to mirror that of the general population.

Surgery for HOCM is currently one of the safest open-heart procedures with mortality risk <1% in experienced centers. Cleveland Clinic has performed more than 3,000 myectomy procedures, with mortality 0.7% and <4.5% of patients requiring pacemakers.?

Learn more about HOCM surgery at Cleveland Clinic in Florida.

TCAR Minimally Invasive Alternative to Open CEA

Until recent years, open carotid endarterectomy (CEA) has been the standard of care for many patients with severe or symptomatic carotid stenosis. However, minimally invasive procedures such as transfemoral carotid stenting and now transcarotid artery revascularization (TCAR) have emerged as safe and effective minimally invasive alternatives for patients with carotid disease.

The Department of Vascular Surgery at Cleveland Clinic in Florida provides multispecialty care and access to the industry’s most advanced technology and procedures, which now includes the use of TCAR for many patients in need of carotid interventions. When compared to traditional open CEA, studies have shown that patients undergoing TCAR usually recover quickly with less pain and smaller scars.

According to Morris Sasson, MD, a vascular surgeon with Cleveland Clinic Weston Hospital and Co-Director of Cleveland Clinic’s Vein Center in Florida, TCAR patients also have a lower risk of cardiac complications, myocardial infarction and cranial nerve injury, and have a shorter procedure time when compared to open CEA.

Read more about this innovative treatment for carotid stenosis.

After Years Without a Diagnosis, Woman Gets Lifesaving Heart Surgery

Marianela Betancourt remembers that even as a kid she was often short of breath when she played sports. But, starting about 15 years ago, Marianela had a series of setbacks that led her to believe her condition was more serious.?

Over the years, she found herself in an ER many times due to falls or her heart beating “out of control.” In 2019, the ER doctor caring for Marianela referred her to Craig Asher, MD, a cardiologist at?Cleveland Clinic Weston Hospital.

After extensive testing and a consultation with Nicholas Smedira, MD, a cardiothoracic surgeon at Cleveland Clinic’s main campus in Ohio, Marianela was diagnosed with hypertrophic cardiomyopathy.

In December of 2019, Marianela underwent?mitral valve repair?and a clipping of the atrial appendage, and?myectomy?(removal of some of the hardening of the heart muscle) due to a stiffening of her heart’s left ventricle.

Marianela says she recommends Dr. Asher and Cleveland Clinic to everyone she can. “I’m doing fantastic. I have not had one episode since my surgery,” Marianela says. Read her entire story here.

Learn more about the Hypertrophic Cardiomyopathy Center.

Learn more about referring your patients to Cleveland Clinic in Florida.