Transcatheter valve replacement

[DSOB]

One of my law partners brought this article to my attention when he saw it in the Washington University alumni magazine. You have to scroll down to nearly the end of the page to get to the valve article.

http://magazine.wustl.edu/Summer08/frontrunners.html

Knowing there were going to be advancements like this was what allowed me to choose a bovine valve and avoid Coumadin. When I need a new one in 15 or so years Dr. McCoy from Star Trek will probably just pass a little gizmo over my chest for 20 seconds and all will be well, right?

 

[netmiff]

here in Canada we are doing valve implants by artery/vein (not sure of the correct technical terms). Mostly in Vancouver and Ottawa I think, and on patients who are too old or otherwise not healthy enough to stand OHS. If I can find further info I will post.

 

[briansmom]

Oaktree,
That is good information in your post. I was not aware that they worked like that.

 

[Adrienne]

My cardiologist who is at the Montreal Heart Institute participated (along with one of the surgeons there) in a transcatheter aortic valve replacement for a woman who was not able to undergo OHS because of other problems. This was a couple of years ago, I believe.

 

[CThrock]

Thanks for posting thats great information...

 

[Dawn-Marie]

Hi Dennis ~ Thank you for the article. Thank you too, Oaktree for your information. I still don't know if i'll be getting this percutaneous aortic valve. It may be another month before i hear back from Cleveland Clinic. My cardiologist(s) said i needed to get my valve replaced within 1 1/2 months back in early April, since it is very critical now. Dr. Strzalka intended to operate, but he kept taking 3 or 2 week vacations so i didn't even get surgery scheduled until July 17th. Then a combination of my pulmonary function tests (which i didn't even score high enough to register on) and what a new doctor at Flagship CVTS (where Dr. Strzalka is) said scared him off from operating on me, plus the fact that he flipped at me when i said i wouldn't stay on a ventilator forever. So, i guess this is my only chance at not dying, so i'll probably go for it if i meet the strict criteria. Everything has to be perfect before they will do it. You have to have really large arteries so they can thread it up through them, plus your heart has to be the right size, and who knows what else. I know Dr. Strzalka said i would have to run back and forth to Cleveland several times over a several month period being evaluated. This is if after looking at the information and CD's of all my tests that i'm even a possible candidate. Even if i do qualify for it, it is a BLIND STUDY, so a computer will decide if i get the percutaneous valve, a valvuloplasty (which i've already been told by a Cardiologist in Erie that my valve is too calcified to be able to open with a balloon valvuloplasty, or just medicine (which i've been told won't work for me either). Like you said, this is in the clinical trial stage still, so i would be a guinea pig. The nurses i talked to at Cleveland Clinic all told me there will be no guarantees...some people are alive, but many more are dead. There are still a lot of risks!

I hope this will be a viable solution in the future...once it is perfected it will be so much easier for people to go through. I'm really scared right now as it isn't perfected and i really don't like being a guinea pig. I don't have much in the way of any other options though right now.

Thanks again for the information.

 

[Debbie]

oaktree

oaktree

Dear Oaktree, thanks for posting the info. I also toured Edwards a few months ago, and I recommened any VR's that take a trip to CA go visit, it's very intresting! My surgeon said with out a doubt my next surgery(in 15-20yr) will be transcathter. I just hope I don't have any other heart problems before that Debbie

 

[DSOB]

Dawn-Marie:

I will keep you in my thoughts, and hopefully you will be approved and then will be a "lucky recipient" of the stented valve.

Blind studies are by their very nature disheartening (pardon the pun), as you never know if you got the cutting edge possible lifesaver or not.

In June I was selected for a blind study of an anti-biotic gel sheet to be placed under the sternum before they wire and glue you back together after OHS. It was to cut down on infections and promote healing. They've been doing it in Europe for a few years. I went to the hospital and filled out all of the paperwork, but on the morning of my surgery my surgeon advised me that he had pulled me off the study. While he was one of the investigators in the study, he only did it for bypass surgery, not for valve replacements. That was fine with me, but unlike you, my life and/or lifestyle didn't depend on inclusion in the study.

Please keep up up-to-date on your hopeful inclusion in the study, and good luck.

 

[Susan BAV]

...In June I was selected for a blind study of an anti-biotic gel sheet to be placed under the sternum before they wire and glue you back together after OHS. It was to cut down on infections and promote healing. They've been doing it in Europe for a few years. I went to the hospital and filled out all of the paperwork, but on the morning of my surgery my surgeon advised me that he had pulled me off the study. While he was one of the investigators in the study, he only did it for bypass surgery, not for valve replacements. That was fine with me, but unlike you, my life and/or lifestyle didn't depend on inclusion in the study...

I have some kind of surgical material my surgeon placed between my heart and my sternum before wiring me back together. The purpose, since I have a tissue valve, is at least in part to help a reop to be easier with less scarring and reducing attachment between my heart and sternum, maybe somewhat similar to what you are describing.

 

[Dawn-Marie]

Hi and thank you DSOB ~ I talked with Dr. William Stewart's secretary today. He's the cardiologist who my heart surgeon in Erie sent all my information to. He is involved in The Partner Study at Cleveland Clinic. It will be Dr. Lars Svennson who will perform the actual surgery (i guess it's called surgery). She said he has made his decision as to if i'm a candidate or not for the valve, but she doesn't know what his decision is. She said i should be hearing from him in the near future.

I really hope i'm at least a candidate. I'm feeling worse and worse. Now my legs and feet are really swollen and my left foot is turning black and blue on top since my heart is not strong enough to pump the blood back up my legs. My whole body is swelling to some extent, but not as bad. I'll let you know if i'm a candidate when i hear from him. If not, i guess there are no other options according to my heart surgeon in Erie.