First TEAVR Performed in Georgia at Georgia Heart Institute



A local north Georgia firefighter/paramedic is back on the job after getting a new heart valve through robotic surgery that was the first of its kind ever done in Georgia. Brian Mills underwent a totally endoscopic aortic valve replacement (TEAVR) at Northeast Georgia Medical Center (NGMC) Gainesville, and he was able to go home just 48 hours later.

“I asked them, ‘What do I got to do to get out of here this weekend,’” said Mills, 51. “And that’s what we did.”

Aortic valve replacement surgery typically involves opening the patient’s chest, which leads to recovery that can take months, or somewhat less invasive techniques. But Mills’ doctor – T. Sloane Guy, MD, a cardiothoracic surgeon with Northeast Georgia Physicians Group (NGPG) Cardiovascular & Thoracic Surgery and Georgia Heart Institute – chose to use the DaVinci surgical robot. Dr. Guy conducted the whole procedure through a series of tiny incisions in the patient’s right armpit.

“Aortic valve replacement has been done with sternotomy but also through minimally invasive procedures with thoracotomy,” Dr. Guy said. “Those are great operations, but my life’s obsession has been to make incisions smaller and smaller and help patients recover as quickly as possible.”

Mills’ journey to a new aortic valve began when he got a fever that wouldn’t go down. He went to an urgent care center, where tests showed he had an extremely low white blood cell count. He then went to the emergency room at NGMC Gainesville for more tests to draw cultures to check for infections. The day after Mills left the ER, he was called to come back immediately. Mills had endocarditis, a serious infection of the heart tissue.

“Brian had lived for years with a leaky aortic valve, and it hadn’t caused him any problems,” said Preston Ball, MD, an emergency medicine physician at NGMC. “Now, however, the leakage had gotten much worse, either due to the infection or having just progressed over time.”

Mills would need a new aortic valve. Dr. Guy wanted to operate immediately, but Mills says he talked the surgeon out of it. “I was ready to go home,” Mills said.

The doctors agreed to send Mills home to take IV antibiotics for six weeks. With the infection gone, he would be ready for his new valve. He had a choice between a mechanical valve or a tissue valve.

“With mechanical, they told me it’s one and done,” Mills said. “You are good for the rest of your life.”

Getting a mechanical valve, however, meant taking blood thinner medication.

“With my job as a paramedic firefighter, there’s no way,” said Mills, who served for 17 years. “I would have to worry about nicking or bumping my head and having to bleed. So, we chose the tissue valve and went that route.”

Dr. Guy, who performed the first robotic heart surgery at NGMC Gainesville in February 2023, decided Mills would be a good candidate for robotic surgery – and the rest is now history.

“We did our annual physical training test at work a couple of weeks ago, and it was really crazy how quickly I recover after exertion now,” Mills said. “It’s pretty amazing. Even the person doing the vital signs before and after said, ‘Wow, you recovered quicker than anybody!’ I said, ‘Well, there’s some new hardware in there. It probably does work a little better.’”

To schedule an appointment with NGPG Cardiovascular and Thoracic Surgery, call 770-212-3054. To schedule an appointment with one of Georgia Heart Institute’s cardiologists, visit georgiaheartinstitute.org or call 770-534-2020.