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6 | Health Matters: Providence St. Joseph Hospital really, in minimally invasive heart procedures and surgeries. We are now able to do many procedures that go through the blood vessels instead of doing traditional open- heart surgery. And at Providence St. Joseph we are fortunate to be on the cutting edge of this technology." Take, for instance, the transcatheter valve replacement program that Drs. Raney and Kolski started at Providence St. Joseph Hospital in 2016. The TAVR procedure is for patients who have damage to the aortic valve—the valve that feeds the largest blood vessel in the body and gets oxygen to all our vital organs. "Over time, for some people," explains Dr. Tyler, "the valve wears down and gets calcified and narrow. This is called severe aortic stenosis, a life-limiting condition, and historically the only treatment for it was open-heart surgery, which puts a lot of stress on the body and risks complications, both from the surgery and the anesthesia." He continues, "Now we have a procedure that allows us to replace the heart valve through a minimally invasive approach via the blood vessel in the leg. Our patients are under light anesthesia, and after the procedure they wake up and generally start walking around within a few hours and go home the next day. It's a transformative procedure." The TAVR program is so successful that Dr. Raney and other team members share their knowledge and skill to train other physicians and clinicians in the procedure. The MitraClip technology has been available for about 10 years and is designed for those with a mitral valve that has become progressively leaky, which can lead to heart failure and sudden death. According to Dr. Kim, "The MitraClip is a device that allows us to repair leaky mitral valves using catheters without open-heart surgery and has been proven to reduce both heart-failure-related symptoms and death associated with severely leaky mitral valves. While there are still some patients who benefit from open-heart surgery to repair or replace their mitral valves, there are a growing number of patients with leaky mitral valves who cannot undergo surgery and are better candidates for MitraClip." Says Dr. Tyler. "We go through blood vessels in the leg and, guided by ultrasound and X-ray imaging, put in clips that stop the leaks. We are currently among the top three hospitals in California for this procedure and have had extremely good outcomes. In fact, the most challenging cases in the area get sent to us here." Watchman is a procedure for those with a heart arrhythmia know as atrial fibrillation, which predisposes patients to a higher risk of stroke because the heart is not pumping as efficiently and leads to blood clots forming in the heart. Says Dr. Kim, "The Watchman device is an effective alternative to blood thinners for those patients who cannot safely take blood thinners long-term. It reduces the risk of stroke without the risk of bleeding that can come with long-term use of blood thinners." The procedure is done by going up to the heart through a vein in the leg and inserting a kind of closure device called an occluder into the heart. "Patients often go home the same day or the next morning. It's remarkable," adds Dr. Tyler. The PFO closure procedure, also done by accessing the heart through blood vessels in the legs, repairs holes in the heart. The structural heart program at Providence St. Joseph is the highest- volume catheter-based heart valve program in Orange County, with outcomes in the top 10% of the nation. According to Dr. Kim, "St. Joseph Hospital is in the top 25 of over 500 MitraClip programs nationwide. And we are also the only 3-star TAVR COULD YOU HAVE CAROTID ARTERY DISEASE? A live virtual event with Meena Archie,MD, vascular surgery THURSDAY, JUNE 23 | 12–1 P.M. Join us for a live virtual presentation hosted by vascular surgeon Meena Archie, MD, to learn about transcarotid artery revascularization (TCAR), a clinically proven, minimally invasive procedure to treat carotid artery disease and help prevent future strokes. Register today by calling 877-227-3457. program [the highest designation awarded by the Society of Thoracic Surgeons] in Orange County." According to Dr. Kolski, "Between the structural programs, the clinical trials and the heart recovery program for people who have had cardiogenic shock [heart attack], Providence St. Joseph's is the hospital in Orange County offering the most cutting-edge programs for structural and ischemic heart disease. It's very exciting."

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