M
Marge
Not directly on point to valves, but an interesting article in today's New York Times on developing treatments for end-stage heart failure (a possible alternative to heart transplant surgery). This is an excerpt. You can read the whole article at http://www.nytimes.com/2004/07/19/science/19HEAR.html?hp
You will need to register if you are not already registered with the NYT, but registration is free and, as far as I have been able to tell, harmless. After a certain time period -- a week? -- you have to pay to read NYT articles online.
<<The experiment, at 90 centers around the world, is to include 2,800 patients who will be followed for seven years. Sponsored by the National Heart, Lung and Blood Institute, it is called Stich, for surgical treatments for ischemic heart failure. (The word ischemic refers to inadequate blood flow.)
Mr. Ray joined Stich and was assigned at random to undergo a risky operation at Ohio State University Medical Center, which would include bypass surgery to improve blood flow to his heart muscle as well as a more drastic procedure: cutting open his heart to reshape it, get rid of some scar tissue and help it pump more efficiently. For comparison purposes, others in the study will receive medicine alone, or medicine and bypass surgery.
Mr. Ray's surgeon, Dr. Robert E. Michler, chief of cardiothoracic surgery at Ohio State, said the study was being done because doctors did not know the best way to treat patients like Mr. Ray, with scarred, failing hearts and blockages in the arteries that feed blood to the heart muscle itself. Although there is a standard regimen of drugs, studies have not proved whether surgery can help. But some patients have surgery anyway.
"We truly do not know the answer as to which therapy is best for these patients," Dr. Michler said. "I have a personal feeling that surgery will prove better, but that's completely explainable by the fact that I'm a surgeon and this is what I do. But I also believe in trying to do things scientifically, in an evidence-based way."
In heart failure, the heart is weak and cannot pump enough blood to keep up with the body's needs. The major causes include damage from heart attacks, blocked or narrowed coronary arteries, diseased heart valves, high blood pressure and diabetes.
Five million Americans have heart failure. There are 550,000 new cases a year and 53,000 deaths. The condition contributes to another 200,000 deaths a year. Drugs and implantable defibrillators may prolong survival for some patients, but the disease still takes years off people's lives: 20 percent die within a year of the diagnosis, and 80 percent of men and 70 percent of women under 65 die within eight years. The number of cases has risen in recent years as the population has aged and more and more people survive heart attacks.
As heart failure progresses, the heart often enlarges and changes shape. As Dr. Michler explained, the left ventricle, the main pumping chamber, should be shaped like a football, but gradually dilates, becoming more like a basketball and losing its ability to contract properly. The surgery in the Stich trial is meant to reshape the ventricle and make it as much as 30 percent smaller. >>
You will need to register if you are not already registered with the NYT, but registration is free and, as far as I have been able to tell, harmless. After a certain time period -- a week? -- you have to pay to read NYT articles online.
<<The experiment, at 90 centers around the world, is to include 2,800 patients who will be followed for seven years. Sponsored by the National Heart, Lung and Blood Institute, it is called Stich, for surgical treatments for ischemic heart failure. (The word ischemic refers to inadequate blood flow.)
Mr. Ray joined Stich and was assigned at random to undergo a risky operation at Ohio State University Medical Center, which would include bypass surgery to improve blood flow to his heart muscle as well as a more drastic procedure: cutting open his heart to reshape it, get rid of some scar tissue and help it pump more efficiently. For comparison purposes, others in the study will receive medicine alone, or medicine and bypass surgery.
Mr. Ray's surgeon, Dr. Robert E. Michler, chief of cardiothoracic surgery at Ohio State, said the study was being done because doctors did not know the best way to treat patients like Mr. Ray, with scarred, failing hearts and blockages in the arteries that feed blood to the heart muscle itself. Although there is a standard regimen of drugs, studies have not proved whether surgery can help. But some patients have surgery anyway.
"We truly do not know the answer as to which therapy is best for these patients," Dr. Michler said. "I have a personal feeling that surgery will prove better, but that's completely explainable by the fact that I'm a surgeon and this is what I do. But I also believe in trying to do things scientifically, in an evidence-based way."
In heart failure, the heart is weak and cannot pump enough blood to keep up with the body's needs. The major causes include damage from heart attacks, blocked or narrowed coronary arteries, diseased heart valves, high blood pressure and diabetes.
Five million Americans have heart failure. There are 550,000 new cases a year and 53,000 deaths. The condition contributes to another 200,000 deaths a year. Drugs and implantable defibrillators may prolong survival for some patients, but the disease still takes years off people's lives: 20 percent die within a year of the diagnosis, and 80 percent of men and 70 percent of women under 65 die within eight years. The number of cases has risen in recent years as the population has aged and more and more people survive heart attacks.
As heart failure progresses, the heart often enlarges and changes shape. As Dr. Michler explained, the left ventricle, the main pumping chamber, should be shaped like a football, but gradually dilates, becoming more like a basketball and losing its ability to contract properly. The surgery in the Stich trial is meant to reshape the ventricle and make it as much as 30 percent smaller. >>
