Cardiologists at WellSpan Health offer innovative procedures while continuing to advance care for patients with heart valve disease and other noncoronary heart conditions.
Patients with structural heart disease often require advanced, specialized care. The multidisciplinary team at WellSpan Health is committed to providing patient-centered care while working collaboratively to improve technology and develop even better techniques.
“Everybody here has one goal: to take the best care of the patient,” says James Harvey, MD, MSc, FACC, FSCAI, Vice President and Chief Medical Officer for the Heart and Vascular Service Line and Director of the Structural Heart Program at WellSpan Health. “Active involvement, communication, understanding and respect for every discipline’s abilities lead to the best possible outcomes.”
This team-based approach has helped WellSpan Health become a regional leader in the treatment of structural heart disease, offering the latest treatments for a wide range of conditions. These include an improved technique for transcatheter aortic valve replacement (TAVR), as well as an enhanced procedure for implanting the WATCHMAN device for left atrial appendage closure in patients with nonvalvular atrial fibrillation.
Leadership in TAVR
Before the TAVR procedure existed, open-heart surgery was the only option for patients with severe aortic stenosis. The minimally invasive TAVR approach, which became widely available a decade ago, allowed the surgeon to replace the diseased valve with an expandable valve through a catheter. Dr. Harvey and the WellSpan Health team began exploring avenues for improvement, as an average of 25% of patients needed a pacemaker following the procedure.
“The way the valve went in and where it was deployed could interact with the conduction system,” Dr. Harvey says. “In some cases, there wouldn’t be optimal hemodynamics, which meant the valve wasn’t opening as well as we would like.”
James Harvey, MD, MSc, FACC, FSCAI
In collaboration with a team at University of Pittsburgh Medical Center, the WellSpan Health team developed a new technique for the TAVR approach that reduced the need for a pacemaker to as low as 3%. This technique has now become a best practice throughout the U.S., Canada and Europe, with WellSpan Health teaching other specialists around the world through in-person training and live video demonstrations.
Enhancing the WATCHMAN FLX procedure
The WATCHMAN left atrial appendage closure device has made it possible for many people with atrial fibrillation to live without the need for blood thinners. In 2020, the WellSpan Health cardiology team implanted the first WATCHMAN FLX device, which improves upon the original WATCHMAN device by making it even safer and available to more patients. The team also became the first to implant the device using intraprocedural CT scan for real-time guidance. The procedure was performed in the country’s first 4DCT angio suite. The team recently published results in the Journal of the American College of Cardiology.
“Having one of the highest volumes on the East Coast for implanting the WATCHMAN device, we were able to identify a need and pioneer a new way of doing things,” Dr. Harvey says. “Using the CT scan-based approach, we can achieve truly superior results.”