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Structural Heart & Valve Clinic

The Structural Heart & Valve Clinic at Mary Washington Hospital focuses on assessing patients dealing with aortic valve stenosis. This condition arises when the aortic valve becomes narrower, causing a blockage in the blood flow from the heart to the rest of the body through the aorta. As the condition worsens, the heart becomes weaker due to the increased effort needed to pump blood across the narrowed valve.

For those facing aortic stenosis, there's a technique called TAVR (transcatheter aortic valve replacement). It's a minimally invasive surgical method that offers a treatment option for patients who might not be suitable candidates for the traditional open heart surgery due to moderate risk or other reasons.

If you're experiencing symptoms related to aortic stenosis, it's a good idea to discuss your situation with your cardiologist. They can guide you through an assessment at Mary Washington Hospital's Valve Clinic to explore potential alternative treatment plans.

Collaborative Heart Care Team

Mary Washington Hospital’s Structural Heart & Valve Clinic Team consists of specialists with various areas of expertise who review each patient’s tests and results to develop a customized treatment plan.

John Cardone, MD, and Alex Na, MD, cardiothoracic surgeons; Arijit Chanda, MD, and Micaela Iantorno, MD, interventional cardiologists, work with cardiologists and primary care physicians in the region to make life-saving aortic stenosis treatment options available to patients.

A multidisciplinary heart team reviews patient test results in conjunction with the patient’s cardiologist or referring physician to determine an appropriate treatment plan which may include Transcatheter Aortic Valve Replacement (TAVR), surgical aortic valve replacement or medical therapy.

A dedicated Valve Clinic Coordinator assists potential patients with navigating the evaluation and testing process and facilitates the recommendations of the Collaborative Heart Team and referring cardiologist.

TAVR – Transcatheter Aortic Valve Replacement

TAVR (transcatheter aortic valve replacement) is a minimally invasive surgical technique that makes heart valve replacement a treatment option for many patients who have aortic stenosis but are considered moderate risk or are not surgical candidates for traditional open heart surgery. TAVR is a less invasive option that enables surgeons to use a catheter to guide an artificial heart valve through the carotid artery or an artery in the groin -- directly into the heart, position it within the patient’s native heart valve and implant the new valve allowing it to restore blood flow.

Because it is less invasive, TAVR typically has a shorter recovery time and lower risk for complications than traditional open heart surgery. Post-procedure hospitalization is typically 2-4 days. Risks for stroke and other complications are similar to traditional surgical valve replacement. Your physician can help you determine the best treatment options based on your condition.

Learn more about TAVR

Cardiac Hybrid Room

Mary Washington Hospital’s Cardiac Hybrid Room, designed specifically for TAVR procedures, combines equipment and features found conventional operating rooms with state-of-the-art imaging technology.

Please contact your cardiologist with additional questions or for a referral to one of our surgeons.

TAVR room

WATCHMAN: A One-Time Implant that Helps Reduce AFib Stroke Risk

Mary Washington Hospital adds Watchman treatment for Atrial Fibrillation to its heart patient services.

How Does AFib Increase Stroke Risk?

The average person with atrial fibrillation (also called AFib or AF) is five times more likely to have a stroke than someone with a regular heartbeat.1 That’s because AFib can decrease the heart’s pumping capacity by as much as 30%.2 Because blood isn’t pumped out of the heart normally, it’s easier for blood cells to stick together and form clots in an area of the heart called the left atrial appendage (LAA).2, 3 When a blood clot escapes from the LAA and travels to another part of the body, it can cut off the blood supply to the brain, causing a stroke.1, 4

An Alternative to Blood Thinners

WATCHMAN is a permanent implant that offers an alternative to the lifelong use of blood thinners. It’s about the size of a quarter and made from very light and compact materials commonly used in many other medical implants.


WATCHMAN effectively reduces the risk of stroke by permanently closing off the LAA to keep blood clots from escaping. WATCHMAN can eliminate the bleeding risks and regular blood tests and food-and-drink restrictions that come with warfarin. In a clinical trial, 9 out of 10 people were able to stop taking warfarin just 45 days after the WATCHMAN procedure.6

How is WATCHMAN Implanted?

WATCHMAN is implanted into your heart in a one-time procedure. To implant WATCHMAN, your doctor makes a small cut in your upper leg and inserts a narrow tube, as done in a standard stent procedure. Your doctor then guides WATCHMAN into your heart’s LAA. The procedure is done under general anesthesia and takes about an hour. Patients commonly stay in the hospital overnight and leave the next day.

After the Procedure

Following the WATCHMAN procedure, you’ll take warfarin for 45 days or until your LAA is permanently closed off. During this time, heart tissue will grow over the implant to form a barrier against blood clots. Your doctor will monitor this process by taking pictures of your heart to see when you can stop taking warfarin.

Your doctor will then prescribe a medicine called clopidogrel (also known as Plavix®) and aspirin for you to take for six months. After that, you’ll continue to take aspirin on an ongoing basis. A very small number of patients may need to keep taking blood thinners long term.

In a clinical trial:

  • 92% of patients were able to stop taking warfarin just 45 days after the procedure6
  • 99% of patients were able to stop taking warfarin within 1 year after the procedure6
Is WATCHMAN Right for You?

If you have a history of bleeding or a lifestyle, occupation or condition that puts you at risk for bleeding, WATCHMAN may be right for you. But like any medical procedure, WATCHMAN comes with risks, so it isn’t right for everyone.

Your cardiologist will weigh your risk of a stroke against your risk of a serious bleeding problem to determine the right treatment for you.

1. National Stroke Association. Making the Afib-Stroke Connection. Published 2012. Accessed September 1, 2016.
2. Harvard Health Publications. Atrial fibrillation. Harvard University Medical School. Published November 2011. Accessed August 25, 2016.
3. Blackshear JL, Odell JA. Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation. Ann Thorac Surg. 1996;61:755-759.
4. Cleveland Clinic. Atrial fibrillation (Afib). Published May 2015. Accessed August 25, 2016.
5. National Stroke Association. Making the Afib-Stroke Connection. Published 2012. Accessed September 1, 2016.
6. Holmes DR Jr, Kar S, Price MJ, et al. Prospective randomized evaluation of the Watchman Left Atrial Appendage Closure device in patients with atrial fibrillation versus long-term warfarin therapy: the PREVAIL trial. J Am Coll Cardiol. 2014;64(1):1-12.
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