Diseased heart valve replaced through small chest incision

Feb 10, 2009

When 91-year-old Irvin Lafferty was diagnosed with severe blockage of his heart valve—hardening that is formally known as aortic valve stenosis—open-heart surgery was out of the question. He'd already survived quadruple bypass while in his 50s, and having lived almost a century, Lafferty wasn't a good candidate for heart surgery for many reasons. His local cardiologist referred him to surgical and interventional specialists at Chicago's Bluhm Cardiovascular Institute of Northwestern Memorial Hospital. And, on January 21, 2009, Lafferty became the first patient in Illinois to receive a prosthetic heart valve through a procedure known as transapical transcatheter aortic valve implantation, which combines catheterization technology and traditional surgery, allowing doctors to implant a new heart valve in place of Lafferty's diseased valve while his heart remained beating.

"Traditional open-heart surgery is a very safe and effective way to replace diseased heart valves, but for many patients bypass surgery is not a viable option" says Patrick M. McCarthy, MD, Northwestern Memorial's chief of cardiothoracic surgery and co-director of its Bluhm Institute and a Heller-Sacks professor of surgery at Northwestern University's Feinberg School of Medicine. "By utilizing the percutaneous technique—meaning surgery is not required—we are able to greatly reduce risk for these patients. We see percutaneous valve repair as not only having a great impact upon how high-risk patients are treated, but in how heart valve disease is treated period, in the U.S. and around the world."

McCarthy is a co-principal investigator for the clinical trial that provided Lafferty's new heart valve, which is formally referred to as the Placement of AoRTic TraNscathetER Valve, or PARTNER. The Bluhm Institute is among the trial's pioneering sites. McCarthy says the procedure builds upon a routine catheter-based procedure, the balloon aortic valvuloplasty.

"Balloon aortic valvuloplasty has been traditionally offered as a palliative therapy for patients who were not candidates for aortic valve surgery," said the hospital's Director of the Cardiac Catheterization Laboratory Charles J. Davidson, MD, who is also a co-principal investigator for the trial and a professor of medicine at Northwestern University's Feinberg School of Medicine. "This particular technique is a more durable treatment than balloon valvuloplasty and is potentially a breakthrough for treating high-risk patients."

Medical experts estimate every year nearly 200,000 people in the U.S. need new heart valves. Yet over half of them do not receive them primarily due to frailty, one of the most common reasons for exclusion from traditional open-heart surgery.

"Surgery becomes far too risky when patients are conditionally weak or frail," says Chris Malaisrie MD, a Northwestern Memorial cardiac surgeon and member of the site team evaluating this new procedure. "The goal is to replace diseased valve at minimal risk to these patients—many of whom have very limited therapeutic options. Aortic valve replacement is one of few therapies offering both symptomatic relief and improved long-term survival."

During insertion, the artificial valve remains collapsed until it reaches its destination. It is then expanded and released in place of diseased aortic heart valves. The prosthesis is made of stainless steel and biological leaflets that help direct the flow of blood in the heart. It is permanent and integrates an expandable stent that holds the valve in its intended position. Northwestern Memorial utilizes both the transfemoral (through the groin) and transapical (through the ribs) approaches. Implantation occurs in a hybrid operating room suite that incorporates elements of both a traditional OR and catheterization laboratory.

Source: Northwestern Memorial Hospital

Explore further: AbbVie shares sink after $21 bn deal for Pharmacyclics

add to favorites email to friend print save as pdf

Related Stories

New Hampshire bill requires cursive, multiplication tables

52 minutes ago

As schools adopt new education standards and rely more on computers in the classroom, a group of New Hampshire senators want to make sure the basics of learning cursive and multiplication tables don't get left behind.

Recommended for you

US must respond to global health outbreaks, say bioethicists

12 hours ago

Last summer, West Africa fell into the grip of a deadly outbreak of Ebola that has thus far taken the lives of more than 9,500 people. The fear swept up by the epidemic quickly jumped across the Atlantic and landed in the ...

Uganda on defensive over medical 'brain drain' uproar

Mar 03, 2015

Uganda's government on Tuesday hit back at mounting criticism of plans to 'export' over 200 health workers to the Caribbean, insisting it was only seeking to regulate an existing labour market and prevent abuses.

Seth Mnookin on vaccination and public health

Mar 02, 2015

Seth Mnookin, an assistant professor of science writing and associate director of MIT's Graduate Program in Science Writing, is the author of "The Panic Virus: The True Story Behind the Vaccine-Autism Controversy" ...

User comments : 1

Adjust slider to filter visible comments by rank

Display comments: newest first

holmstar
not rated yet Feb 10, 2009
The only important info here is the last paragraph... filler, filler, filler.

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.