Widely considered a surgery of last resort, many patients with heart valve disease are too weak to withstand open-heart surgery.
“In an open surgery you have to actually crack the chest, open up the sternum, stop the heart and put it on bypass. Then physically go in and open the valve, remove the calcium and then sew in a new valve,” says Dr. Stephen Priest, cardiologist with Lee Memorial Health System’s medical staff.
But newer FDA approved procedures are opening the surgery to more people who need it, by allowing surgeons to take a new approach.
“Whereas the patient can be completely off bypass; they are under some sedation, but it can be done with a beating heart,” says Dr. Priest.
Proving there’s more than one way to a person’s heart, this new, transcatheter approach has two variations. The first is to deliver a new valve via catheter inserted through an artery in the leg, and threading through the circulatory system to the heart. The second approach is to enter directly through the chest wall.
“We prefer to go through the groin if possible, but a lot of these patients have bad peripheral vascular disease (PVD) and it becomes dangerous for them. So the new approach has allowed us to take those high- risk patients and go directly in through the chest and avoid all of those potential vascular problems,” says Dr. Paul DiGiorgi, cardiothoracic surgeon on the medical staff of Lee Memorial Health System.
The underlying condition, aortic stenosis affects nearly 1.5 million Americans. By the time they are diagnosed, most are already in crisis.
“Once you start having symptoms of aortic stenosis the average survival is only a year and a half. Very serious disease once you start showing symptoms. Essentially that valve is so bad there’s nothing that’s going to make it better, other than replacing it,” says Dr. DiGiorgi.
And now, there is new hope for those severely ill patients who feared they were too sick to be saved.