Valvular Heart Disease Center

The Center for Valvular Heart Disease, which was formed in 2005, is a multidisciplinary program that is dedicated to advancing the understanding of valvular heart disease and providing outstanding care for patients with these disorders. This center is comprised of team of general cardiologists, interventional cardiologists, cardiac surgeons and nurses with expertise in the latest catheter-based therapies, as well as state-of-the art surgical options for patients with valvular heart disease.

The Center for Valvular Heart Disease Center was the first program in the St. Louis metro region to perform the transcatheter aortic valve replacement (TAVR) surgery and continues to enroll patients in the latest clinical trials. The center has grown exponentially since its inception and now offers separate clinics at the Center for Advanced Medicine located on the Barnes-Jewish main campus, as well as the Heart & Vascular Center in our West County location.

Our team

Our multidisciplinary team of expert physicians and nurses includes:

• Alan Zajarias, MD, Co-Director (Interventional Cardiology)
• Hirsch Maniar, MD, Co-Director (Cardiothoracic Surgery)
• Sanjeev Bhalla, MD (Cardiac Imaging)

• Andrew Bierhals, MD (Cardiac Imaging)
• Marci Damiano, RN, MSN (Nursing Valve Coordinator)
• Ralph Damiano, Jr. MD (Cardiothoracic Surgery)
• John Lasala, MD, PhD (Interventional Cardiology)
• Majesh Makan, MD (Cardiac Imaging)
• Spencer Melby, MD (Cardiothoracic Surgery)
• Marc Moon, MD (Cardiothoracic Surgery)
• Julio Perez, MD (Cardiac Imaging)
• Nishath Quader, MD (Cardiac Imaging)
• Pamela Woodard, MD (Cardiac Imaging)

Clinical expertise

• Cardiologists dedicated exclusively to diagnosing and managing valvular heart disease
• Risk stratifying the asymptomatic patient to determine optimal timing of surgery
• Integration of clinical, imaging, and invasive data to determine the appropriate timing of intervention
• Patients are seen together by both a cardiologist and cardiac surgeon to determine an optimal treatment strategy regarding which patients are candidates for catheter-based vs. surgery for aortic and mitral valve disease

Interventional expertise

• High volume center for transcatheter aortic valve replacement (TAVR) using both transapical and transfemoral approaches
• Experienced with the transcatheter mitral valve repair procedure
• Balloon aortic, mitral, pulmonic valvuloplasty
• Availability of transcatheter pulmonic valve implantation
• Closure of prosthetic paravalvular leaks

Surgical expertise

• High volume center for valve surgery, both repair and replacement
• Minimally invasive surgical options
• Reconstruction of the aorta performed on its own or concomitantly with aortic valve surgery
• Surgical MAZE procedure for atrial fibrillation
• High risk and/or re-operative surgical procedures 

Expertise with multimodality cardiac imaging

We offer advanced multimodality imaging for the evaluation of patients with valve disease, including:

• 2-D and 3-D echocardiography
• Cardiac magnetic resonance imaging (MRI)
• Cardiac computerized tomography (CT)