True Grit: Healing a Cowboy’s Heart


At 85, James Domingos is still enjoying life as a cowboy, thanks to a transcatheter aortic valve replacement.

Always rolling with the punches when it comes to life, 85-year-old James Domingos faced his health issues with the same grit.

For many years, he roped cattle for friends and rounded up horses for the Bureau of Land Management. In recent years, a pacemaker controlled the rhythm of his heart, but didn’t slow him down.

“We used to be able to take walks for 15 minutes in one direction and take the dog,” says Domingos’ wife, Joy. “Then it got to be less and less.”

Tests at Renown Health revealed a heart valve was nearly closed.

His heart doctor, Jake Ichino, MD, FACC, FSCAI, suggested a transcatheter aortic valve replacement, known as TAVR, which repairs a heart valve without removing the damaged valve. The procedure is recommended for patients who are at high risk for open heart surgery.

Institute for Heart & Vascular Health

Renown Health’s Institute for Heart & Vascular Health is the region’s leader in heart care. We have the most advanced medical, surgical and minimally invasive treatment techniques available today, while our vascular surgery program is the largest and most experienced diagnostic and treatment center for vascular problems. Our rapid treatments and record-setting arrival-to-treatment times are among the best in the nation.

RELATED:  TAVR: Less Invasive, Faster Recovery Than Open-Heart Surgery

A week before his procedure, Domingos was hospitalized with pneumonia. True to his cowboy roots, he had a little shot of brandy first thing when he got home. And from there, he got stronger and stronger by the day, until he was ready to return for the procedure.

“He got really good care,” Joy says, “And they all felt like a family, too, so you were comfortable with them.”

Although Domingos’ horse-riding days are over, roping is still in his blood. He’s looking forward to gathering old friends to watch cattle branding in the spring.

“I’ve got all my family here and that means a lot to me,” he says. “I just want to stay healthy. I don’t want to be a burden to nobody. So far, I’m pretty healthy.” 

Learn more about Renown’s Institute for Heart & Vascular Health at


  1. Congratulation to the TAVR heart team and all who cared for him during his stay at Renown. Your care and life-saving work is giving him more time with his family. Awesome job!