Heart valves implanted sans surgery

January 8th, 2009 - 4:31 pm ICT by IANS  

Washington, Jan 8 (IANS) An innovative approach for implanting a new aortic heart valve sans open-heart surgery is being offered to patients at NewYork-Presbyterian Hospital and Columbia University Medical Centre or CUMC.Known as the PARTNER (Placement of AoRTic traNscathetER valves) trial, this Phase 3 multi-centre study is being led by national co-principal investigators Martin Leon and Craig Smith and is focused on the treatment of patients who are at high risk or not suitable for open-heart valve replacement surgery.

Leon, the study’s national co-principal investigator is associate director of the Cardiovascular Interventional Therapy (CIVT) Program at NewYork-Presbyterian Hospital and CUMC.

The transcatheter valve procedures take about 90 minutes, compared with four to six hours for open-heart surgery. In open-heart surgery, the surgeon cuts through the breastbone, stops the heart, removes the valve and replaces it.

Open-heart surgery can require a two-to three-month recovery period, compared to only a few days for the transcatheter approach.

The transcatheter heart valve, made of bovine pericardial tissue leaflets hand-sewn onto a metal frame, is implanted via one of two catheter-based methods — either navigated to the heart from the femoral artery in the patient’s leg, or through a small incision between the ribs and into the left ventricle.

It is then positioned inside the patient’s existing valve, using a balloon to deploy the frame, which holds the artificial valve in place. Both procedures are performed on a beating heart, without the need for cardiopulmonary bypass and its associated risks.

“This breakthrough technology could save the lives of thousands of patients with heart valve disease who have no other therapeutic options,” said Leon. Annually, some 200,000 people in the US need a new heart valve, but nearly half of them do not receive a new valve for a variety of reasons.

“This study may show that transcatheter valve replacement is a safe and effective alternative to open surgery, which remains the ‘gold standard’ for most patients,” said Smith.

The PARTNER trial is a prospective randomised study with two separate treatment arms. In the surgical arm, patients are randomised to receive either the Edwards SAPIEN transcatheter heart valve or an Edwards surgical valve via open-heart surgery, said a CUMC release.

In the non-surgical, medical management arm, patients considered to be non-operative are randomised to receive either the Edwards SAPIEN transcatheter heart valve or appropriate medical therapy.

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