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As well as the first patient, 79-year-old Tauranga woman Ramona Johnson, the others were 79-year-olds from Otorohanga and Tokoroa, a 60-year-old Gisborne man, and a 91-year-old Hamilton woman.
Sanjeevan Pasupati, one of a few cardiologists in the world with experience in the procedure, said the five operations went well.
The operation involves replacement of a deteriorated main heart outflow valve with another one, in Ms Johnson's case via the leg.
The second woman to have the operation yesterday - a 91-year-old - had the valve inserted via her neck and her recovery was slower, Waikato District Health Board (DHB) spokeswoman Mary Anne Gill said.
The procedure only required a local anaesthetic and had a shorter recovery time.
Conventional aortic valve replacement by open-heart surgery was the preferred procedure, but required general anaesthetic and had a long recovery time.
The alternative could be used for patients with some medical conditions and the elderly, when open-heart surgery was not an option.
The operations were funded by the Waikato Heart Trust and an individual who gifted over $300,000 for the valves. The DHB planned to prepare a business case for the Ministry of Health so they can continue in the public sector.
Waikato Hospital head of medicine Clyde Wade said while the hospital could not compete internationally for prospective employees on salaries, it hoped to attract staff by offering cutting edge equipment.