subject: Advancements In Cardiac Surgery [print this page] Heart valve disease is one area that can benefit from hybrid and percutaneous/endovascular procedures. Heart valve disease refers to conditions that prevent one or more of the valves in the heart from opening and closing properly, which can lead to the development of a valve that does not open wide enough (stenosis) or a valve that is leaky (regurgitation). The symptoms of untreated heart valve disease can reduce a person's quality of life and overall survival.
Although open heart surgery is the traditional method to repair or replace severely damaged heart valves, and most patients can undergo open heart surgery without difficulty, there are new, less invasive techniques that can treat these conditions. Using a pioneering pin hole approach method through a groin vessel, a surgeon can utilize a valve on a catheter without opening the chest. This revolutionary approach is currently offered to treat patients who cannot undergo surgery because their heart function is too severely compromised. These novel approaches are just as effective as open heart surgery to restore normal heart function and help patients return to a normal function and routine quickly.
A major advancement in the management of heart valve disease is the transcatheter aortic valve replacement (TAVR), a new minimally invasive technique for replacing a diseased aortic heart valve. TAVR delivers a collapsible artificial valve into the heart using a catheter, inserted under advanced imaging through a small incision in the groin vessel or between the ribs. The artificial valve is expanded inside the native valve by inflating a balloon, and almost immediately goes to work.
The US Federal Drug Administration (FDA) recently approved the Edwards SAPIEN transcatheter aortic heart valve, for the treatment of inoperable patients with severe symptomatic aortic stenosis. SAPIEN is the first U.S. commercial approval for a transcatheter heart valve device enabling aortic valve replacement without the need for open-heart surgery and the Hoag Heart and Vascular Institute (HHVI) is the first institute in Orange County to provide this revolutionary new technique to patients.
"TAVR is a major milestone in the advancement of treating aortic valve heart disease," says Aiden Raney, M.D., F.A.C.C., medical director of cardiovascular surgery at Hoag Heart & Vascular Institute and the James and Pamela Muzzy Endowed Chair. "Until now, so many patients did not have an option for treatment of aortic stenosis."
Senile aortic stenosis is an age-related hardening of the valve and most patients are not fit for surgery. These patients that have been turned down for conventional surgical replacement of the aortic valve are now candidates for TAVR. "A large percent of patients with aortic stenosis are older and therefore will benefit greatly from TAVR," adds Dr. Raney. "TAVR can help improve patients'' longevity, but most importantly it can help improve overall quality of life."
The recent Edwards trail that led to the FDA approval of SAPIEN, showed 69 percent survival of patients that received SAPIEN versus 50 percent survival in patients that received an alternative treatment. Edwards estimates approximately 500,000 people in the US suffer from severe aortic stenosis.
