The excitement surrounding minimally invasive heart valve procedures continues to build. In addition to mini-sternotomy ^[1] approaches, mini-thoracotomy ^[2] techniques and robotic surgery, transcatheter technologies ^[3] 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) ^[4] 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 ^[5] 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 ^[5].
• The most common post-procedural complications ^[6] 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 ^[7] 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 ^[8]. 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.

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