New technology offers alternative to open heart surgery - A study published in Journal of Interventional Cardiology found that a variety of advances have allowed for the potential treatment of MR through various catheter techniques, similar to angioplasty. The study reports on the first phase of a clinical trial that employed this new treatment method on surgical candidates with moderate-severe and severe MR. The procedure involved the positioning of a guide catheter in the left atrium of the heart, far less invasive than open heart surgery. "The procedure has been accomplished safely and a significant reduction in MR has been achieved in the majority of patients treated," according to Dr. Ted Feldman, lead researcher of the study. "Open-heart surgery for aortic valve replacement is a very common procedure, but many of those who need it are too old or too sick to qualify for the surgery," Damiano says. "That fact led to the development of these Transcatheter valves. An earlier, small feasibility study showed that the mortality rate with the valves was nearly as low as that of conventional valve replacement surgery — around 10 percent."
The Transcatheter technique does not require stopping the heart and placing the patient on a heart-lung bypass machine, so frailer or sicker patients can tolerate the procedure. Without valve replacement, the life expectancy of patients with severe aortic stenosis is very short, usually less than five years. Two groups of patients will take part in the PARTNER trial. The surgical arm of the trial will consist of patients with severe aortic stenosis who are considered at high-risk because of their disease, but who nevertheless are candidates for conventional open-heart surgery. The other arm will consist of patients with severe aortic stenosis who are considered inoperable because they are unlikely to survive open-heart surgery. Success in the surgical arm is achieved if the clinical results demonstrate that the Transcatheter heart valve is not statistically inferior to conventional open-heart surgery. The clinical results of the other arm need to demonstrate that the Transcatheter heart valve is statistically superior to medical management.
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