The treatment, already approved in Europe, could help thousands of people like Miller who are too sick to survive the rigors of open-heart surgery.
"This is going to be a paradigm shift in how we treat" heart-valve patients, predicted interventional cardiologist Howard C. Herrmann, who co-led the operation yesterday.
Still, the procedure is not yet approved by the Food and Drug Administration, and other surgeons have different ideas about how future valve surgery will be conducted.
An estimated 57,000 aortic valve replacements were done in 2006, according to an Inquirer analysis of the National Hospital Discharge Survey. That compares with 444,000 who got bypass surgery that year.
About 3 percent of patients undergoing traditional valve procedures die, but that rate jumps to 8 percent or higher for patients in their 80s and 90s, doctors say.
Yesterday afternoon, Miller, nicknamed Fuzzy when he started at the Pennsylvania Railroad as a 17-year-old in 1955, was wheeled into a "hybrid" operating room at Penn for the 35-minute procedure.
He was the 19th patient to undergo this experimental valve replacement at Penn, the only area hospital participating in a national trial of the device and procedure.
"This is radical, revolutionary surgery," said Joseph E. Bavaria, a heart surgeon who performed Miller's operation along with Herrmann, an expert at unplugging clogged arteries with wire mesh devices called stents.
The new procedure requires the expertise of both kinds of doctors.
"I think joint programs are going to be the key," Herrmann said. "Both specialties will have something to offer here."
The valve, made of cow tissue, is housed in a stent. The entire device is collapsed around a balloon and a guide wire.
