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A Heart-to-Heart With Dr. Azeem Latib

The new Montefiore Structural Heart Program at White Plains Hospital provides patients with the most advanced minimally invasive procedures for complex heart valve conditions.

By Melissa Pheterson

Led by Dr. Azeem Latib, an international expert in interventional cardiology, the Structural Heart team works collaboratively with the Hospital’s cardiac surgeons to provide an optimal care plan to ensure the best possible outcome and quickest recovery.

Dr. Latib’s clinical focus is on complex coronary interventions as well as transcatheter repairs for the aortic, mitral, and tricuspid valves. This fall, he brought the cutting-edge Transcatheter Aortic Valve Replacement (TAVR) procedure to White Plains Hospital. We sat down with him for a chat.

What makes the Montefiore Structural Heart Program at White Plains Hospital unique?

Dr. Latib: The most important thing is our heart-team approach, which is an established best practice for treating complex cardiac procedures. Being multi-disciplinary and patient-centered, we have interventional cardiologists, cardiac surgeons, and imaging specialists working to evaluate options and create an optimal care plan.

Next is advances in imaging. We can now perform comprehensive CAT scans — from neck to legs — to evaluate patients and create a treatment strategy with detailed precision, including selecting the correct valve type, proper valve size and determining where to place the valve.

Finally, we draw upon the latest clinical data and science. The first TAVR procedure was done in 2002. Since that time, there have been 10-15 trials evaluating TAVR even as the technology has evolved. For example, the newest generation of replacement aortic valves are tinier than ever and have sealing caps to prevent leakage. These advances and evidence-based protocols have allowed our valve procedures to become reproducible, safe, and even less invasive.

Which conditions are treated in the Structural Heart Program?

Dr. Latib: We treat patients with valvular problems and congenital problems of the heart by offering an alternative solution to cardiac surgery. Currently, we are performing TAVR procedures at White Plains Hospital, replacing damaged aortic valves minimally invasively and in under an hour, resulting in immediate relief for the patient. Next, we plan to introduce cutting-edge procedures to replace mitral valves and tricuspid valves.

We also offer closure for the Patent Foramen Ovale, or PFO, which is a hole between the two upper chambers of the heart. One in four individuals have PFOs, but the majority never know it. For most, it causes no adverse health effects, but for some, this condition can allow blood clots to pass through the heart to the brain and cause a stroke — especially in young people. Through a minimally invasive procedure in our Cardiac Catheterization Lab, our team expertly closes the hole, reducing the risk of a future stroke. Knowing a simple outpatient procedure can eliminate the risk for stroke provides peace of mind for patients and their families.

Which breakthroughs are you incorporating into your practice?

Dr. Latib: We are using ultrasound guidance for vascular access that has drastically reduced vascular complications, using embolic protection (small filters in the arteries going to the brain) in all our TAVR procedures and doing research on new aortic valves that will give us even more predictable results and last longer. We can now also offer patients with mitral and tricuspid regurgitation a toolbox of different devices to both repair and replace these valves.

What drew you to practice interventional cardiology at White Plains Hospital?

Dr. Latib: In addition to my role at White Plains Hospital, I am also Medical Director of Structural Heart Interventions at Montefiore Einstein. Throughout my career, I have always tried to help people with severe illness and little hope to feel better or who have been told nothing can be done for them. My patients who undergo TAVR have told me that even a few hours later, they can suddenly breathe better. Six hours after one patient’s valve replacement, I couldn’t find him in his bed because he was walking laps around the floor!

I am excited to be part of the team that introduced the Montefiore Structural Heart Program at White Plains Hospital because I live in Westchester and raise my family here. It is very important to me that my neighbors have access to the highest level of care, and the best physicians possible in the community where they live and work. Practicing here is giving back to my community.

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