Just happened to have this up in a different window when I read your post, so here goes:
New procedure replaces aortic valve without open-heart surgery
Jan 23 (HeartCenterOnline) - Surgeons have announced the first case of heart valve replacement performed without open-heart surgery. The procedure, known as percutaneous heart valve implantation, was described at the 15th Annual International Symposium on Endovascular Therapy (Miami Beach, Florida) on January 20, 2003.
Led by Dr. Martin Leon, of Lenox Hill Hospital (New York, N.Y.), the case involved a 57-year old patient with valvular stenosis, a condition in which there is a narrowing, stiffening, thickening, fusion or blockage of one or more valves of the heart. The narrowed (stenosed) valve(s) may interfere with blood flow through the heart, and from the heart to the arteries that lead to the rest of the body via the aorta, or the lungs via the pulmonary artery. Normally, blood flows smoothly through the valves when they open. When a narrowed valve is unable to keep the blood from flowing freely, the heart must work harder to compensate for the lack of adequate blood flow. Over time, this overload can damage the heart's lower chambers (the ventricles) and upper chambers (atria). This may be accompanied by other conditions, such as the following:
*Damage to the heart muscle (myocardium)
* Enlargement and thickening (hypertrophy) of the heart muscle
*Congestive heart failure, which causes congestion in the lungs (pulmonary congestion) and/or swelling (edema) in the legs
*Valvular regurgitation, in which blood is leaking back through a valve in the wrong direction.
Typically, a diseased or defective valve is replaced with an artificial (prosthetic or mechanical) valve or a tissue valve (from a pig or cow). The standard technique has been an open-heart surgery that requires the use of a heart-lung machine. The patient needed replacement of the aortic valve, which connects the aorta to the heart's lower left chamber (ventricle). However, the patient's overall condition was too unstable and was deemed not a candidate for the surgery.
The new procedure is still in the experimental stages. It involves the use of balloon catheters and large stents introduced through a puncture in the skin (in the groin area, near the femoral vein) as opposed to open-heart surgery. The new heart valve is transported via the stent to the site, where the stent is then expanded to implant the valve. The patient showed great improvement following the procedure, both in the severity of his congestive heart failure and in his ability to resume some normal activities.
For patients not able to undergo open-heart surgery, due to age and/or physical condition, percutaneous valve implantation may impact significantly on survival and quality of life. "Anytime you can do less invasive treatment in critically ill patients, you reduce morbidity and you improve results," said Dr. Leon. "If in the future," he continued, "we can demonstrate that these valves are durable, that we can do the procedure repeatedly, reliably and safely, it may, in fact, be competitive with surgical valve replacement under many circumstances."
In 2003, studies of percutaneous valve implantation are scheduled to take place in Europe and in the United States.
