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Surgeon brings minimally invasive heart procedure to YRMC

Yuma resident Marco Cota says he received the greatest gift imaginable for his 44th birthday, a heart operation that ended a decade of extreme fatigue, while also making history at Yuma Regional Medical Center (YRMC).

Yuma resident Marco Cota says he received the greatest gift imaginable for his 44th birthday, a heart operation that ended a decade of extreme fatigue, while also making history at Yuma Regional Medical Center (YRMC).

Dr. Ramaswamy Ravikumar, the director of Cardiovascular Surgery and Minimally Invasive Surgery at YRMC, performed a minimally invasive aortic valve replacement (AVR), the first procedure of its kind ever performed at YRMC. The procedure fixed a leaky heart valve that had left Cota feeling tired and always short of breath.

Prior to this recent procedure, all aortic valve replacements at YRMC were performed through open-heart surgery, which requires surgeons to cut through patient's breastbone or sternum. In this case, however, Dr. Ravikumar was able to use a minimally invasive technique involving a small incision between the ribs. That radically smaller incision, along with the less-invasive entry into the body, means far less pain for the patient, fewer associated risks and a much speedier recovery.

"I feel really well. Since I woke up, I've felt awesome," Cota said just a few days following the procedure, a day after his birthday and just hours before being discharged. "I am working on getting better every day. I am very happy."

Dr. Ravikumar gently held his hands against Cota's and encouraged him to push.

"Look. Look at that! See how strong he is, even so soon after the operation," the surgeon said. "Patients who have the regular, traditional surgery would never been able to push like this."

Dr. Ravikumar pointed to the patient's two-inch scar, stressing that the traditional, more invasive approach typically involves an incision running between the neck and the belly button.

The surgeon noted that he believes more and more cardiac procedures will soon be performed in a minimally invasive manner, with YRMC leading the way.

He said that 90 percent of aortic valve replacements actually should be good candidates for the minimally invasive approach. The challenge, he explained, is fellow surgeons around the nation and world readying themselves to graduate to this newer approach, which he said is more technically challenging for the surgeon.

"Very few surgeons have the expertise and the experience to perform this minimally invasive surgery. Probably only 10 percent of cardiothoracic surgeons can perform this," Dr. Ravikumar said. "This is cutting-edge for Yuma. This is the most advanced method for this heart surgery that is available now, right now as we are talking."

Dr. Ravikumar, whose work prior to YRMC established his reputation as a pioneer of robotic heart surgery, is certainly not a stranger to performing surgeries hailed as being the first of their kind.

Dr. Ravikumar's medical career includes the following highlights:

  • World's first robotic double valve replacement in 2011
  • World's first robotic combined mitral valve replacement and coronary artery bypass graft in 2011.
  • India's first robotic aortic valve replacement in 2010.
  • India's first robotic mitral valve replacement in 2006.
The surgeon told Cota that he could expect a relatively rapid recovery following his minimally invasive surgery.

"With the old procedure, it takes two to three months to heal," Dr. Ravikumar explained. "With most of my patients who have this surgery, when they come to see me two weeks after the procedure, they are driving their own car. The patient is able to be active again so much sooner with this approach. They certainly love that."

Dr. Ravikumar recalled one particularly happy patient from a previous hospital, back when he worked in Alabama.

"That patient told me that he felt guilty after having his minimally invasive aortic valve repair. I asked him what he meant," the surgeon said. "He explained that when he saw everyone who had the invasive approach walking around so slowly and with so much pain – he felt guilty. He asked why everyone can't have this less invasive surgery."

Dr. Ravikumar graduated from Stanley Medical College in India. He later obtained the Fellowship of the Royal College of Surgeons (FRCS), the professional qualification needed to practice as a senior surgeon in the United Kingdom. He worked in London at Harefield Hospital under Sir Magdi Yacoub.

He conducted his surgical residency in Boston, followed by his cardiothoracic residency in Dallas at the University of Texas, South Western Medical Center in Dallas. He continued serving that institution as an advanced fellow in heart and lung transplant who is UNOS (United Nations Organ Sharing) certified.

Yuma Regional Medical Center: is a 406-bed, not-for-profit hospital dedicated to providing outstanding medical care to the residents of Yuma and the surrounding communities in southwestern Arizona. The YRMC team includes more than 2,000 employees, 300 medical providers and hundreds of volunteers who work closely together to create a welcoming, caring, and compassionate environment for patients and their families.

Patient Marco Cota (center) poses for a picture at Yuma Regional Medical Center with his friend, Gloria Aguirre, and the surgeon who recently performed Cota's minimally invasive heart surgery, Dr. Ramaswamy Ravikumar with Yuma Regional Medical Center.

Yuma Regional Medical Center: is a 406-bed, not-for-profit hospital dedicated to providing outstanding medical care to the residents of Yuma and the surrounding communities in southwestern Arizona. The YRMC team includes more than 2,000 employees, 300 medical providers and hundreds of volunteers who work closely together to create a welcoming, caring, and compassionate environment for patients and their families.

Media Contact:
Darin Fenger
Dfenger@yumaregional.org
(928) 336-7545
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