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The Most Experienced TAVR Facility in the Midlands

Reaching a significant milestone in comprehensive cardiovascular care for the people of our community, Lexington Medical Center has become the most experienced hospital in the Midlands for transcatheter aortic valve replacement, known as TAVR. The procedure allows doctors to replace the heart’s aortic valve with a catheter instead of open heart surgery.

Lexington Medical Center is celebrating the one-year anniversary of beginning its TAVR program. So far, the hospital has performed more than 60 TAVR procedures, more than any other hospital in the Midlands. TAVR is considered the greatest advance in cardiology since coronary angioplasty.

Currently, TAVR is for patients with severe aortic stenosis who are high-risk candidates for open heart surgery because of their age, history of heart disease, or other health issues.

Lexington Medical Center's TAVR Team. L to R: Jeffrey Travis, MD; Robert Malanuk, MD, FACC; Kristen Davis, MSN, RN, CCRN; Robert Leonardi, MD, FACC; Dee Prastein, MD

Lexington Medical Center’s TAVR Team. L to R: Jeffrey Travis, MD; Robert Malanuk, MD, FACC; Kristen Davis, MSN, RN, CCRN; Robert Leonardi, MD, FACC; Dee Prastein, MD

“We feel so lucky to be able to help these people, many of whom are debilitated by heart failure and did not have any good options in the past,” said Dr. Robert Leonardi of Lexington Cardiology at Lexington Medical Center, who works with a team of clinicians on the hospital’s TAVR team.

Patients with severe aortic stenosis have a narrowed aortic valve that does not allow blood to flow efficiently. As the heart works harder to pump enough blood through the smaller opening in the valve, the heart eventually becomes weak. Over time, that can lead to life-threatening heart problems.

To replace the diseased aortic valve with TAVR, the new aortic valve is compressed into a catheter. Doctors thread the catheter through the body to the inside of the diseased aortic valve.

Then, they deploy the new valve inside the diseased aortic valve, which becomes the anchor for the new valve. The new valve is functional immediately and normal blood flow is restored.

Lexington Medical Center performed the first fully percutaneous TAVR procedure in South Carolina. With this minimally invasive technique, doctors deployed the new aortic valve through just a small puncture in the femoral artery in the leg. The hospital also performed the first TAVR procedure in South Carolina where the patient was awake, and it remains the only South Carolina hospital routinely doing the procedures fully percutaneously, without putting patients to sleep, and without the need for a transesophageal echocardiogram. This “minimalist” approach has been shown to make recovery from valve replacement easier.

Lexington Medical Center hosted a reception on the hospital campus in May with patients who underwent TAVR, clinicians and hospital employees.

To learn more about cardiovascular care at Lexington Medical Center, visit

Ask the Doctor: Coronary Bypass Surgery

Dr. Dee Prastein, heart surgeon at Lexington Cardiovascular Surgery, was invited to be a guest on WIS-TV to talk about coronary bypass surgery. The topic was in the news after Bob Coble, the former mayor of Columbia, suffered a heart attack and underwent a bypass procedure.

In the first segment, she talked about how bypass surgery is performed.

In the second segment, she discussed recovery.

Lexington Medical Heart Center has performed more than 800 open heart surgeries since the program began in 2012. For more information, visit

The Doctor Is In: Women and Heart Disease

From raising children to maintaining busy work schedules and keeping up with household chores, women’s lives are more hectic than ever. Women often put everyone else in their family first, but it’s important that they take time for their own health.

Dr. “Dee” Prastein, heart surgeon at Lexington Cardiovascular Surgery, a Lexington Medical Center physician practice, talks about women and heart disease, encouraging all of us to “Just Say Know.”

Prastein_Labcoat_Standing_ORWhat differences have you noticed between men and women with heart disease?
Women tend to delay things, living with heart disease longer and presenting later. We see women who go about their routine chores while having chest pain or chest discomfort, ignoring or dismissing it. Sometimes they live with symptoms until they become so tired that they physically can’t do anything. It’s only then that they see a doctor.

What do women tell you about why they didn’t see a doctor sooner?
They seem to be focused on everyone except them. They put their families first. We see wives encouraging their husbands to see a doctor, but women often live with symptoms until they can no longer hide them.

How can heart surgery be different for men and women?
Women do really well with heart surgery because they seem to tolerate pain better than men. Also, older patients often tolerate pain better than younger ones.

How does smoking affect our hearts?
Nicotine causes hardening of the blood vessels, making them more stiff and narrow. That hardening of the arteries makes blockages more apparent sooner. You could say nicotine is the opposite of nitroglycerin, which allows blood vessels to become bigger.

What about diabetes?
With diabetes, high levels of sugar in your bloodstream allow the buildup of plaque in every blood vessel in your body, including the arteries in your heart.

What message do you have for women about heart disease?
I want women to know that it’s not normal to have no energy or to have chest discomfort such as pain or burning. If you do, see your doctor. Women who smoke, have a family history of heart disease or have diabetes should be especially careful. Don’t ignore symptoms. We can treat them and prevent a major heart attack.