Clinical Update: Transcatheter Aortic Valve Replacement From Germany (With Patient Video)
April 25th, 2009The excitement surrounding minimally invasive heart valve procedures continues to build. In addition to mini-sternotomy approaches, mini-thoracotomy techniques and robotic surgery, transcatheter technologies are being closely watched-and-monitored for clinical success.
A transcatheter solution for patients suffering from aortic valve stenosis (the narrowing of the aortic heart valve) is most likely to be of most benefit for elderly patients for whom the risk of open heart surgery would be too great.
Calcified Aortic Valve With Stenosis
The most recent surgical results obtained specific to this minimally invasive technique for aortic valve replacement at the German Heart Center in Munich, Germany suggests:
- From June 2007 to September 2008, aortic valvular prostheses were successfully implanted with the transcatheter technique in 150 patients with high-grade aortic stenosis.
- The 30-day mortality was 11.8%, which can be compared to a figure of 24% for conventional aortic valve replacement surgery.
- The most common post-procedural complications were cardiac arrhythmia, vascular problems, and cerebrovascular events.
- Six months after the procedure, the patients’ clinical condition had markedly improved with good hemodynamic functioning of the new prostheses.
Calcific aortic stenosis is the most common acquired heart valve defect in Western countries, with a prevalence of more than 3% in persons over age 75. Up to the present time, the treatment of choice for high-grade aortic stenosis has been surgical aortic valve replacement.
As many as 60% of patients, however, cannot be operated on because of advanced age and major comorbidities, even though they suffer from severe symptoms and have a poor prognosis under conservative treatment.
The advantage of transcatheter valve implantation is that it can be performed on the beating heart without the need for a heart-lung machine. In the procedure, an aortic valve prosthesis crimped to fit inside the catheter is brought into aortic position and then unfolded. The Edwards SAPIEN valve is one of the industry’s leading transcatheter solutions (shown below).
Here is a patient testimonial for the Edwards SAPIEN solution for minimally invasive aortic replacement surgery. At 88, Joseph Riley, had the procedure done successfully in 2008.
Keep on tickin!
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| About The Author: Adam Pick is a double, heart valve surgery patient and author of The Patient's Guide To Heart Valve Surgery. This unique book integrates clinical research with the personal experiences of 135 former patients to help future patients and their caregivers better understand the problems, the opportunities and the realities of heart valve surgery. To learn more about Adam and his heart valve surgery book, click here. |
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