St Vincent’s team milestone 200th TAVI procedure gets patients back in the swing of life

St Vincent's Private Hospital Northside

The team at St Vincent’s Private Hospital Northside has been doing the lifesaving and lifechanging TAVI procedure since 2015. Dr Roland Hilling-Smith and Dr Andrew Clarke recently teamed up to perform their 200th procedure enabling cardiac patient Glen Kirkwood to improve his quality of life and able to swing a golf club again.

St Vincent’s Private Hospital Northside continues to reinforce its growing reputation as an Australian leading cardiac hospital, with its team reaching a significant pre-Christmas milestone performing a major lifesaving procedure which has major benefits for an ageing population.

The team of Dr Roland Hilling-Smith and Dr Andrew Clarke performed their 200th TAVI (Transcatheter Aortic Valve Implantation) procedure together – a high-tech repair of the heart’s ‘exit door’ or aortic valve which allows blood to flow from the left ventricle to the rest of the body. 

The minimally-invasive procedure extends the life – and restores the quality of life - of older and more vulnerable patients who would otherwise face significant health challenges from undergoing open heart surgery. 

A recent Australian study found that the severe heart condition, symptomatic aortic stenosis, could affect close to 100,000 Australians and with more than 50 per cent of sufferers expected to succumb to it without treatment. With an ageing population, the number of new cases was likely to compound with another 10,000 cases each year.

The TAVI procedure, which usually takes around an hour, is designed to reduce the impact of the potentially fatal heart problem – a stiffening of the aortic valve leaflet from calcification (which naturally forms over many years), also called symptomatic aortic stenosis.

St Vincent’s Northside has been doing TAVI procedures since 2015 and its expert medical teams had performed a combined 670 procedures by the end of 2023.


St Vincent’s has a world class team of surgeons, nurses and support staff in its Structural Intervention Team with nine accredited operators: Dr Roland Hilling-Smith, Professor Darren Walters, Dr Akshay Mishra, Dr Dale Murdoch, Dr Andrew Clarke, Dr Nicholas Aroney, Dr Con Aroney, Dr Karthik Gopal and Dr Lachlan Marshall.


The first TAVI procedure in the world was done in France in 2002 and while the initial global take-up was gradual, with improving technology and further training of surgeons and medical teams in Australia, it has accelerated rapidly. Cardiologist Dr Roland Hilling-Smith travelled to the UK in 2015 and spent a year training in the TAVI technique and brought his skills and knowledge back to St Vincent’s where the procedure has been embraced by surgeons and patients alike.

Mako Robots

Cardiologist Dr Hilling-Smith has worked in tandem with cardiothoracic surgeon Dr Andrew Clarke and they have just performed their 200th procedure on 200 grateful patients.

“There’s two advantages of the TAVI procedure. Firstly, you can perform what is a lifesaving procedure on older people, especially those in their 70s and 80s – those who might have been too unwell or too frail to come through open heart surgery in good shape,” said Dr Hilling-Smith.

“There’s a massive difference in the recovery – it can be up to six months for open heart surgery for some people. But with the TAVI procedure, they’re usually just in hospital for two nights after the procedure before they can go home and their recovery is usually straight forward. Obviously they don’t need as much post-op care from family and friends than they do after open heart surgery and that’s very beneficial for the patient but also for everyone around them.

“Previously, before we could do TAVI, there might be two years or less of life expectancy for patients with symptomatic aortic stenosis who weren’t deemed suitable for open heart surgery for a range of reasons.

“Now with intervention through TAVI – the patient’s life is extended by around 10 years and their quality of life is usually restored and often enhanced.”

The heart issue is often originally detected by a GP using a stethoscope as part of their annual health check, who might observe a heart murmur. This is then usually followed by a more accurate transthoracic echocardiogram.

Once the patient is referred to a St Vincent’s cardiologist, further tests are completed and St Vincent’s has a heart valve team meeting – which also can involve a geriatrician for older patients – which collaboratively confirms the patient’s suitability for TAVI and how the team will execute the procedure. 

During the TAVI, the operator will usually insert a wire through the groin but if the valves are narrow they might have to go through the patient’s shoulder to access the aorta (this occurs in less than 5% of cases). 

The valve is placed inside a catheter, or flexible tube, and guided through a blood vessel in the groin to the heart, where the deflated surgical balloon is inflated and, rather than replacing the damaged valve, the new one sits securely within it using a stent made of circular metal mesh. The prosthetic valve – made from pig or cow tissue – is inserted, which is effectively like putting a foot into a sock!


“The TAVI procedure has been a game-changer for older Australians and the procedure is now very common. The technology is continuing to improve and our surgical teams, who are already excellent, are getting better at it all the time,” said Dr Clarke.


“Around 1 per cent of the population have congenital heart issues so aortic valve issues can present with anyone in this group at any stage from birth to old age – although most of the procedures we do are in older patients.”


Undergoing TAVI should alleviate most if not all of the patient’s symptoms and generally after a fortnight, when the valve settles into place, they’re able to return to most normal activities. Around 90% of patients enter a six-week cardiac rehabilitation program to provide structure and discipline to their complete recovery pathway.

The lucky recipient of the 200th TAVI at St Vincent’s Private Hospital was 82-year old Glen Kirkwood from the Sunshine Coast who had the procedure 12 years after undergoing open heart surgery to repair a mitral valve.

Glen had increasingly been experiencing spells of shortness of breath and dizziness this year – to the point where he would occasionally feel faint and fall even while seated. He had a pacemaker installed several years ago but found he was not able to keep up his regular walking routine and his passion for playing golf three times a week, albeit on a Par-3 short course.

“To be honest, if the surgeons had said to me that they needed to do open heart surgery again this time to fix the problem, I don’t think I would have had another procedure,” said Glen. 

“The recovery from the last open heart surgery was long and terrible plus I’m 12 years older now, so I don’t know how I would have coped. But when the St Vincent’s doctors told me they could do keyhole surgery, that clinched it for me.”

Glen worked in many different jobs throughout his life across several different states. Originally a carpenter by trade, he spent 25 years working in sales and marketing for glass manufacturer Pilkington Australia – then later in life returned to his trade, building everything from cinema seats to coffins.

“I might have made coffins, but I had no desire to make my own and end up in one of them any sooner than was necessary,” he joked as he prepared for his pre-Christmas surgery.

Two days later, after undergoing what cardiothoracic surgeon Dr Andrew Clarke described as a “straight forward procedure”, Glen was up and out of his hospital bed and heading home just in time for Christmas.

“I feel great and couldn’t be happier. I was walking and moving around the ward the day after the procedure and while I’m a little bit sore in a few spots, I’m feeling good, feeling relieved it’s done and looking forward to relaxing and enjoying Christmas with the family,” said an energetic Glen.

“I can’t wait for the end of the six-week recuperation period the doctor has told me to follow before I can be back swinging a golf club again with my mates and enjoying life.”

Better and fairer care. Always.

In a rapidly transforming world, St Vincent's has created a refreshed vision and strategy to help shape Australia's health and aged care future.