NYP/Columbia Welcomes World Leader in Valve Surgery
Vinayat (Vinnie) Bapat, MD, a world-renowned surgeon with expertise in open heart and minimally-invasive valve surgery, and a pioneer of transcatheter devices, has joined the faculty at NYP/Columbia.
Dr. Bapat developed transcatheter approaches to aortic and mitral valve disease at Guy's and St. Thomas’ Hospital in London where he had the largest practice in the UK in complex valve surgery. He is also known for his contributions to physician education and has created computer applications used by cardiothoracic surgeons around the globe.
Columbia is the national leader in new devices for mitral valve and tricuspid valve surgery. With the addition of Dr. Bapat, this institution will provide new options for heart and valve surgery, helping even the most complex patients.
“Columbia is the right place to spearhead new therapies,” says Dr. Bapat. “It is also known for providing expert opinion on heart and valve conditions. The cardiac team has extensive experience in both conventional and transcatheter procedures and will choose the right option for each patient.”
Dr. Bapat’s groundbreaking contributions include:
Transaortic Valve Replacement (TA0-TAVR)
TAVR is a minimally invasive procedure to treat the aortic valve that leaves the old, damaged valve alone but wedges a full collapsible replacement valve into place using a catheter. Dr. Bapat helped refine this approach at Guy's and St. Thomas’ Hospital, which now has the largest TAVR program in the UK. The new methods he introduced led to improved outcomes for TAVR patients worldwide.
“Eleven years ago, when TAVR was in its infancy, surgeons used to see a high rate of complications,” Dr. Bapat says. “With new techniques mortality rates quickly dropped by 50%, making this a safe and effective procedure. The invention of transcatheter valve is, I believe, the most important development since the heart transplant.”
Keyhole Aortic Valve Surgery
In 2014 Dr. Bapat began performing aortic valve surgery without cutting into the sternum, using a technique known as the Right Anterior Thoracotomy. “Making small, keyhole incisions, we go in through two ribs on the right side, remove the old valve, then implant a suture-less valve,” he says. “The advantages of this less invasive approach are faster healing, less hospital time, and better cosmetic results.”
After open-heart surgery it usually takes patients three months to get back to work. With Right Anterior Thoracotomy, patients are back to normal routine within six weeks—one patient was even back to work in seven days. The threshold for recommending this surgery is much lower since there is no risk of sternal wound infection.
NYP/Columbia will be first hospital in the New York area to offer this procedure, and to train other surgeons with the goal of bringing this approach to as many patients as possible.
Aortic Root Replacement
Aortic root replacement surgery is now fairly common, and Columbia is a world leader in this procedure. However, Dr. Bapat is now developing a more streamlined approach to this operation. “Our goal is to simplify the operation, offering a faster surgery that reduces the bleeding risk by nearly 80%, allowing patients to heal faster,” he says.
Transcatheter Mitral Valve Replacement (TMVR)
Dr. Bapat introduced this technology, working with industry on its early design, and is now the most experienced surgeon in world for transcatheter mitral valve replacement. Columbia will now become the primary medical center internationally for this innovative therapy, with advanced imaging techniques, highly experienced interventional cardiologists led by Martin Leon, MD and Susheel Kodali, MD and surgical specialists working together to achieve optimal results. TMVR is now available at Columbia through clinical trials. Within the next few months, the team will also pioneer a new hybrid form of Transcatheter/Open heart mitral surgery.
Valve in Valve Surgery
Dr. Bapat has made advances in valve in valve (VIV) surgery, now awaiting approval in US. Transcatheter valves can restore the function of failing bioprosthetic mitral, tricuspid, pulmonary, or aortic valves and may be the best valve-replacement option for high-risk patients. In the VIV procedure, the new transcatheter valve is inserted tightly into the opening of the failed prosthetic valve, pushing the old valve leaflets aside.
“Most of our patients don’t want to take Coumadin or warfarin, so they opt for a biological valve or tissue valve,” says Dr. Bapat. “This year the number of valve replacements has risen exponentially and in the future many more patients will require this surgery.”
Dr. Bapat has also developed innovative computer applications for VIV surgery, defining the basic concepts and best practices in this emerging field. These are free to general practitioners, cardiologists, and surgeons. The first application focuses on VIV aortic surgery and the second, on VIV mitral surgery, offering thorough guidance on how to perform these novel procedures. The applications have been downloaded in 116 countries with over 35,000 users, and will be updated as surgeons gain more experience.
Research & Industry partnerships
Dr. Bapat is currently leading two large research projects in collaboration with industry partners with the following aims: Determining what future surgical heart valves will look like, and optimizing the design of mitral rings and valves.