Left to right, cardiologist Alan Zajarias, MD, cardiac surgeon Hersh Maniar, MD, and fellow Brett Grizell, MD, perform a groundbreaking procedure that allows surgeons to implant new heart valves using catheters rather than open-heart surgery. Multidisciplinary collaboration is a key to the procedure’s success.

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), and transcatheter mitral valve replacement and repair. It provides multidisciplinary evaluation to patients with simple and complex valve disease and enrolls 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 and South County locations.


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
  • 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
  • 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 

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

Patient education

Indications for referral

  • Patients with moderate-to-severe valve disease or diagnostic or management dilemmas
  • High-risk surgical candidates who may benefit from a transcatheter or minimally invasive surgical approach
  • Patients requiring simultaneous valve surgery and a MAZE procedure for atrial fibrillation
  • Patients requiring simultaneous aortic valve replacement and aortic reconstruction
  • Patients requiring mitral valve repair

Referring physicians and patients contact:

  • Phone: 855-825-8457
  • Fax: 314-747-1417