Heart surgeons perform world’s first robotic TAVR explant and aortic valve replacement
Heart surgeons with the WVU Heart and Vascular Institute have made a bit of history, performing the world’s first robotic explant of a transcatheter aortic valve replacement (TAVR) device and subsequent aortic valve replacement.
The group already has plenty of experience breaking new ground in the field of robotic-assisted surgery. They developed a robotic aortic valve replacement (RAVR) technique that is now being used all over the world, and performed the world’s first robotic aortic valve replacement and coronary artery bypass (RAVCAB) procedure in 2024.
This latest breakthrough started when Thelma Hyer, a 67-year-old female patient, presented with a failing TAVR valve in addition a leaky mitral valve. She had received her TAVR valve just four years prior, but premature structural valve degeneration had already made a full replacement necessary.
Vinay Badhwar, MD, executive chair of the WVU Heart and Vascular Institute, initially recommended open-heart surgery to remove the failing TAVR valve and then replace her aortic and mitral valves. However, Hyer and her family had hesitations due to her history of scoliosis and arthritis. Badhwar then proposed using robotics as an alternative.
The technology had never been used in this exact way before, but Badhwar was confident in the abilities of both his team and the robotic surgery platform. The group developed a plan, talked it over with the patient, and went forward with the robotic procedure in late May.
The operation—including the TAVR explant and the replacement of both heart valves—appears to have been a success. Hyer was discharged after less than a full week of observation.
“It is a privilege to help evolve the field of robotic heart surgery by innovating techniques and teaching other colleagues around the world,” Badhwar said in a statement. “However, there is no greater reward than seeing the benefit of these efforts in the lives of the patients we are humbled to serve.”
“I’m so thankful I found him, and that I chose to trust the WVU team,” Hyer added. “Other people all over the world with my problem of a failed valve may have this opportunity as well.”
Badhwar worked with several other surgeons on these operations, including Ali Darehzereshki, MD, Goya Raikar, MD, J. Hunter Mehaffey, MD, and Lawrence Wei, MD. Cardiologist Ramesh Daggubati, MD, also provided assistance.
Procedure highlights the risks of implanting TAVR valves in younger patients
TAVR has gained significant momentum as a treatment option for younger patients in recent years. According to Badhwar, Hyer’s TAVR valve failing after less than five years is an example of the risks associated with this trend.
“TAVR is a superb treatment and one we support fully when used appropriately,” he said. “This is ideal for patients who are at higher risk for surgery or of advanced age. However, based on the evidence, international guidelines recommend surgery for patients with aortic stenosis who are of younger age. Unfortunately, when TAVR valves are implanted in patients who are under age 65 or 70 years who have a long life expectancy, and may be of lower risk, we are seeing a surge in patients across the country who are in need of having these valves explanted, largely due to premature failure.”
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.