Navigation Links
New Procedure for Aortic Valve Replacement Looks Promising

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, Sept. 22 (HealthDay News) -- For patients who are too sick to withstand surgery to treat a narrowed aortic valve, a new and less invasive heart procedure might keep them alive, researchers say.

As many as 300,000 Americans suffer from aortic stenosis, a condition that prevents the heart's aortic valve from fully opening and sending blood back into the heart. Because of age or poor health, about 30 percent of those with aortic stenosis can't undergo surgery, the researchers say.

"Aortic stenosis is a high prevalence disease in the elderly, and with an aging population it's becoming more frequent," said lead researcher Dr. Martin B. Leon, director of the Center for Interventional Vascular Therapy at New York-Presbyterian Hospital and Columbia University Medical Center in New York City.

"This is truly a lifesaving procedure for those patients who cannot have surgery and who have this terrible disease," Leon said.

Without a valve replacement, which requires surgery to open up the chest, about 50 percent of patients with aortic stenosis die within two or three years of diagnosis.

For the study, published in the Sept. 23 issue of the New England Journal of Medicine, 358 patients with severe aortic stenosis who could not undergo replacement-valve surgery were randomly assigned to either standard therapy or a new procedure. The patients' average age was 83, and 20 percent were 90 or older, Leon said.

Standard therapy included medication and a procedure called balloon aortic valvuloplasty, which provides some relief but does not alter long-term outcomes.

The new procedure -- transcatheter aortic-valve implantation (TAVI) -- involves routing a large catheter through the femoral artery in the patient's groin into the heart. When the catheter reaches the aortic valve, a balloon inflates and opens the valve. Doctors then implant a cow's heart valve, Leon explained.

The procedure takes less than an hour, and patients leave the hospital after a day or two, he said. Open-heart surgery, on the other hand, can last four to six hours, and recovery may take three months, he noted.

After a year, patients who underwent TAVI had a significantly lower rate of death from any cause compared with patients who got standard therapy (30.7 percent vs. 50.7 percent).

TAVI patients also had a reduced rate of death or re-hospitalization compared with those receiving standard care (42.5 percent versus 71.6 percent respectively), the researchers report.

TAVI patients reported greater reduction in symptoms than the other group, and no valve deterioration was noted during the year after the procedure.

"It's not just the fact they are living longer, they are feeling dramatically better," Leon said.

However, more patients who underwent TAVI had a major stroke (5 percent) in the 30 days after the procedure than those in the standard therapy group (1.1 percent), the researchers note.

Efforts are under way to reduce complications, Leon said.

Another trial is assessing the procedure in high-risk patients who could undergo surgery. "In the future we will be looking at lower-risk patients as well," he said.

Previously, no effective treatments were available for patients with severe aortic stenosis who were not candidates for aortic valve surgery, said Dr. Gregg Fonarow, an American Heart Association spokesman and a cardiology professor at the University of California, Los Angeles. These patients "faced a very high risk of mortality," he added.

"As a result of this impressive new trial and pending FDA approval, transcatheter aortic-valve implantation represents an important therapeutic advance and a new standard of care for this important patient population," Fonarow said.

Dr. William O'Neill, executive dean for clinical affairs at the University of Miami Miller School of Medicine, added that this is one of the top studies of the decade. "I think it's going to be looked at as a true landmark study," he said.

"This will totally change practice," O'Neill added. "If the valves are durable, they will eliminate the need for patients to have open-heart surgery to replace the valves."

More information

For more information on aortic stenosis, visit the U.S. National Library of Medicine.

SOURCES: Martin B. Leon, M.D., professor of medicine, director, Center for Interventional Vascular Therapy, New York-Presbyterian Hospital and Columbia University Medical Center, New York City; Gregg Fonarow, M.D., American Heart Association spokesman and professor, cardiology, University of California, Los Angeles; William O'Neill, M.D., executive dean, clinical affairs, University of Miami Miller School of Medicine; Sept. 23, 2010, New England Journal of Medicine

Copyright©2010 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Ex-President Clinton Undergoes Heart Procedure
2. Ex-President Clinton Said To Be Fine After Heart Procedure
3. Bill Clinton Back Home After Heart Procedure
4. Stereotaxis Procedure Prominently Featured on BBC Documentary From the Heart
5. Study: Choice between stroke-prevention procedures influenced by patient age
6. Medical Ultrasound Now Used in New, Non-surgical Cosmetic Procedure
7. Plastic Surgery Institute of Southeast Texas Offers Milder Anesthesia for Outpatient Procedures
8. The Patients Guide to Vasectomy Reversal Now Available for Free for Increasing Number of Men Requesting the Procedure
9. Nu/Hart Leads The Way With Revolutionary Hair Transplant Procedure
10. Dr. Robert True Responds to a New York Time Article About a New Cosmetic Procedure Called Awake Breast Augmentation
11. New procedure aims to save vision of children with eye cancer
Post Your Comments:
Related Image:
New Procedure for Aortic Valve Replacement Looks Promising 
(Date:12/1/2015)... ... December 01, 2015 , ... ... Rehabilitation P.C.went to NASDAQ to educate the personnel on spinal decompression therapy and ... the spine, a nonsurgical procedure. The benefits come from creating negative intradiscal pressure ...
(Date:12/1/2015)... ... December 01, 2015 , ... The Multiple System Atrophy Coalition ... funds for Multiple System Atrophy (MSA) research, timed today to coincide with Giving Tuesday ... from patients including their ability to work and be productive, to do simple daily ...
(Date:12/1/2015)... ... December 01, 2015 , ... ... detailing the important role that meat and poultry play in a healthy, ... poultry, a nutrition quiz where visitors can check their “meat IQ,” a section ...
(Date:12/1/2015)... (PRWEB) , ... December 01, 2015 , ... World ... the Multi Jar, a container patent that allows for easier packing and organizing of ... US is worth $90 billion," says Scott Cooper, CEO and Creative Director of World ...
(Date:12/1/2015)... ... 01, 2015 , ... Henderson, a town of about 6,300 ... through a partnership this year with Aeneas Internet and Telephone. , With faster ... for entrepreneurs who want to build a business. Whether startups or long established ...
Breaking Medicine News(10 mins):
(Date:12/1/2015)... and VANCOUVER , Dec. 1, 2015 ... OncoGenex Pharmaceuticals, Inc. (NASDAQ: OGXI ) announced today ... on the pre-planned interim futility analysis of the intent-to-treat ... safety issues were identified by the DMC. Both the ... final results are expected in the second half of ...
(Date:12/1/2015)... Dec. 1, 2015 As enforcement of the ... Security Act (DSCSA) approaches, InfiniTrak announced ... pharmacies comply with looming FDA regulations. ... entering endorsement agreements with State Pharmacy Associations, an ... organization (PSAO) to exclusively provide the InfiniTrak track-and-trace ...
(Date:12/1/2015)... 2015 ... "Medium Molecular Weight Polyisobutylene Market for ... Applications - Global Industry Analysis, Size, Share, ... report to their offering. --> ... of the "Medium Molecular Weight Polyisobutylene ...
Breaking Medicine Technology: