Rose’s Story: First Endoscopic Aortic Valve Replacement in New England

When Rose Landry, 66, of North Attleborough, learned she would need an aortic valve replacement, she thought she knew what to expect — and did not look forward to it.

“My mother-in-law had an aortic valve replaced in 2003, and I was her support person, so I was not totally in the dark about what this would be,” Rose said. “The recovery was tough.”

Then, Rose met with Tommaso Hinna Danesi, MD, cardiac surgeon at Mass General Brigham and section chief of valve surgery and director of the Endoscopic Valvular Surgery Program at Brigham and Women’s Hospital.

That meeting would change everything for Rose, while also marking a medical milestone.

In January 2024, Rose became the first person in New England to undergo a fully endoscopic aortic valve replacement surgery — completed entirely through a single half-inch incision in her chest. Dr. Danesi, who joined Mass General Brigham last fall to establish the program at Brigham and Women’s, is one of the few cardiac surgeons in the world skilled in the procedure.

“Seeing how quickly patients recover post-operatively from this procedure is the most satisfying thing for me,” Dr. Danesi said. “The first two days feel like a bad flu. You start feeling better by the third day. Then you’re just bored and waiting to go home, which usually happens on day four or five. Because we minimize the surgical trauma, you don’t have any of the normal restrictions after heart surgery. You can lift things, shower, drive and go back to work whenever you’re ready. These may seem like small activities, but they are huge goals for someone who went through open heart surgery.”

Rose, an accountant and grandmother of two, was thrilled to see this reflected in her own experience.

“By the time I left the ICU, I was off all pain meds, including Tylenol,” she said. “Three weeks after the surgery, I couldn’t believe how good I felt. Was I completely back to myself? No, but I was able to take short walks, cook and do laundry on my own. I’ve heard it takes most people three or four months to get to where I was at six to eight weeks after this procedure. Now I am walking 30 minutes a day, going to the gym and working part-time.”

Rose underwent the procedure because she was born with a bicuspid aortic valve, an anatomical defect in the valve that controls blood flow from the body’s largest artery to the heart. In healthy individuals, the aortic valve has three flaps, also known as cusps. A bicuspid valve only has two flaps, which can lead to complications. For Rose, it caused the valve to thicken and narrow over her lifetime, eventually leading to irregular heartbeats and shortness of breath.

Advanced care with compassion

Through the tiny incisions, Dr. Danesi and team would insert surgical instruments and cameras to replace the valve. Like traditional heart surgery, it requires a specialized, multidisciplinary team — including a cardiac anesthesiologist, cardiovascular perfusionist, cardiovascular operating room nurses and other highly trained staff.

“I told her, ‘The operation you’re going to have is exactly the same, from a technical perspective, as open-heart surgery. The difference is the way I get into the heart,’” he said.

The prospect of a quicker, easier recovery made the decision to move forward an easy one, Rose said.

“From that meeting until the actual procedure, I was actually looking forward to and hoping that I would qualify for the totally endoscopic procedure,” she said. “Now, I can hardly believe and cannot adequately express how well my recovery has progressed and how good I feel.”

Rose said she had no concerns about being the first in New England to undergo the novel procedure, thanks to her care team’s expertise and compassionate, patient-centered care.

“Dr. Danesi takes a complete patient approach, expressing concern and understanding of not only the physical but also the mental and emotional aspects of how I felt. He met with me at least once, but typically twice each day that I was in the hospital.  He followed up with me after I was home, via both telephone and email,” she said. “The entire team — the PAs who came in on rounds, the fabulous ICU nurses and so many others — all made me feel like they cared, like it was more than just the job.”

For Dr. Danesi, witnessing outcomes like this illustrates why he is so passionate about making fully endoscopic cardiac surgery available to more patients, including those with other conditions, and training the next generation of cardiac surgeons on the technique.

“I saw Mrs. Rose four weeks after surgery, and she looked great. I couldn’t tell she had open heart surgery just looking her smiling face,” he said. “I was pleased to have restored her quality of life and not have her feel like ‘a heart patient’ for the rest of her life. This is a true minimally invasive experience from admission to discharge.”