The WVU Heart Institute: Advanced Procedures for Cardiac Conditions

By: Jennifer Webster
Monday, January 20, 2014

A radial approach to diagnostic and interventional angiography means safer procedures and faster recovery, while percutaneous aortic valve replacement offers hope to patients who are not candidates for traditional surgery.

WVU Heart Institute is committed to bringing sophisticated technologies and techniques to its patients, says Wissam Gharib, MD, FACC, FSCAI, Director of Cardiac Catheterization Labs at the WVU Heart Institute at Ruby Memorial Hospital and Director of the Cardiovascular Fellowship Training Program at West Virginia University School of Medicine.

“Our team of board-certified interventional cardiologists offers innovative technologies from around the world,” Dr. Gharib says. “We are ensuring high-quality care for patients at WVU.”

Radial Cardiac Catheterization

Traditionally, cardiac catheterization has been performed through the femoral artery, resulting in potential bleeds, as well as several hours of recovery during which a patient must lie supine. Now, physicians at WVU Heart Institute approach through the radial artery instead, using a procedure that allows patients to move around immediately after surgery, with reduced pain and less potential for bleeding.

“This procedure has been done in Europe for a long time, but it is only starting to catch on in the States,” Dr. Gharib says. “This is really an enhanced patient experience for coronary intervention.”

The procedure demands a high level of expertise and technical skill.

“The femoral artery averages 6–7 millimeters across, compared with the radial artery at 2.4 millimeters,” Dr. Gharib says. “You have to be meticulous in order to engage the radial artery. The physician must advance gently, without the support of the aortic arch. We perform this procedure about 3,000 times a year, so we are skilled at it.”

Percutaneous Aortic Valve Replacement

Also known as transcatheter aortic valve replacement, this procedure replaces the aortic valve via a catheter approach through the femoral artery. For patients with aortic stenosis who are not candidates for open heart surgery, or for whom surgery would carry high risk, percutaneous aortic valve replacement offers a new lease on life, as aortic stenosis may lead to chest pain, fainting, heart failure and death.

“The physician makes a small incision in the groin, clamps the femoral artery and places a large-bore sheath,” Dr. Gharib says. “The surgeon then cross the stenotic aortic valve and balloons the aortic valve open. A stent containing the new valve is advanced through the groin into the heart, and once it has been adjusted using echocardiogram and angiography, we deploy the stent valve and deflate the balloon. The new valve begins functioning immediately.”

Retrograde Approach to Coronary Occlusions

Another advanced procedure offered at the WVU Heart Institute involves a retrograde approach to percutaneous coronary intervention (PCI), which circumvents many of the obstacles that can hinder the success of antegrade PCI, such as a long blockage of the artery, severe calcifications and an exceptionally twisted arterial path. PCI can prevent angina, reduce the need for bypass surgery and improve quality of life.

“We are proud to offer transcatheter aortic valve replacement,” Dr. Gharib says. “The procedure is performed in Japan, and we brought it here, enabling us to open arteries that until a few years ago were inaccessible. Our willingness to search out techniques from around the world and bring them to West Virginia makes us unique.”

The WVU Heart Institute in Morgantown is operated by WVU Hospitals. It also offers clinics in Elkins, Fairmont and Grafton. To learn more, please visit