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The TAVR team at UNC Hospitals: from left, John Vavalle, MD, Thomas Caranasos, MD, Michael Yeung, MD, Cassie Ramm, MSN.

June 8, 2016

Thomas G. Caranasos, MD, and John P. Vavalle, MD, on May 3 performed the first suprasternal transcatheter aortic valve replacement using the Aegis Surgical Transit system and the Medtronic Evolut-R valve.

Dr. Caranasos is a cardiac surgeon and assistant professor in the UNC Division of Cardiothoracic Surgery; Dr. Vavalle is an interventional cardiologist and assistant professor of medicine in the UNC Division of Cardiology. With Michael Yeung, MD, of the UNC Division of Cardiology, they direct the Transcatheter Aortic Valve Replacement (TAVR) Program at UNC.

The TAVR operation offers an option for aortic valve replacement to patients who are too frail or ill to undergo open heart surgery. In a conventional TAVR operation, catheters are placed in blood vessels of the groin to thread a new valve up to the chest.

The suprasternal TAVR procedure, developed at UNC, avoids opening the chest for valve replacement and is ideal for patients whose blood vessels are not large enough to allow for the traditional transfemoral access.

The first suprasternal TAVR operation in the United States was performed at UNC in November, but physicians used a different valve and sheath system then.

A big benefit of the suprasternal approach is quick recovery, Vavalle said. The May procedure was successfully completed in under two hours, with the patient up and walking around shortly afterward and sent home from the hospital 48 hours later, Vavalle said.

The UNC Heart Valve team began its transcathether aortic valve replacement (TAVR) program in November 2014 and has treated approximately 50 patients in that time; it is quickly growing into one of the busiest programs in North Carolina.

For more information on UNC’s TAVR program, email Cassie Ramm, M.S.N., nurse coordinator for the program, at or call 1-800-806-1968

– Includes material from a story by Kristen Hendrickson, UNC Department of Medicine.